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everett <br />e � <br />_ <br />� <br />� <br />City of Everett � g $ � � <br />+. L�i' C i~-? 'In <br />� .r-1 �el ti t'�I d ti � <br />o � w o� �� <br />i �'• P �n :a ' .�i� .�n�i • <br />Sewer Appl�cct#�a�r� �ru_ Rerrn�t <br />,���.��, .. <br />� ����������� <br />� � <br />rvo. 25825 � ��.rW���...�== <br />DATE senta�er d, 19e6 <br />Service Address_� <br />Billir,g Address <br />City, State, ? p_..��=�_�3e <br />Ow��er (Mortgagor) <br />Billing Nar.ie A,,, _ <br />Connection By __ <br />Phone <br />DESCRIPTION: <br />Lot �_70 g(�{Fgtsc 59 ,L 58 <br />Plac _ <br />Unplatted Description y 8 <br />Type Permit: <br />Femarks: <br />IMPORTAPIT! <br />CALL 1-800-424-5555 48•HOURS <br />PR�OR TO DIGGING <br />CALL259�8811 FOR INSPECTION <br />SEE SKETCH ATTACHED <br />Utility Account No. <br />Permit Fee�g�ag <br />Connection Charge�s) �68�,.�3 <br />Total Fee��� <br />5pecial Utility Pne, osclin�nce 1271-85 <br />��ta� $ 113.39 <br />seeroi 298,95 <br />3 ;,'•412.34- f :% <br />Signed /�, . � . �i; ; �, . �i <br />Customer � i <br />Sewer District �� ��; <br />Monthly Sewer Service <br />Monthly Sewer Constr. <br />Trunk <br />Lateral <br />Abutting Lot Line <br />N, S, E, W ft. <br />Approved By <br />iry ngineer <br />Issued By m�+-g�e� v w�r...,�. <br />Inspection By <br />Date Inspected �'�L�l <br />INSPECTIGN <br />No. 25$25 <br />