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''�` '' ', � CHART NO. <br /> everett <br /> e �u <br /> 4 <br /> !�t <br /> City of Everett $ a <br /> � g � <br /> Sewer Application and��rmit <br /> � <br /> ua 3 � ,��, <br /> 4 <br /> No. 25850 DATE <br /> /'0//S�2�r'���li-,_.; i . , ,_ <br /> Service Address � • � 'f� � i '� .�; : '' / Utility Ar.count No. <br /> . , / ��i <br /> Billing Address � ��� � �� f�� � : ,• f . r� 1,.� Permit Fee � � <br /> City,State, Zip �f ' i-t f ��:`� Connection Charge(s) <br /> Owner (Mortgagor) f � � �/� Total Fee_�oo ' 6�+1r <br /> Billing Name ` � <br /> � i I ! /` <br /> Connection By <br /> � � <br /> ' J � �- v � Signed ' ; <br /> AdC�f855 \Customer <br /> Phone ' ' �1 <br /> DESCRIPTION: Sewer District <br /> Lot Block Monthly Sewer Service <br /> Plat <br /> Unplatted Description Monthly Sewer Constr. <br /> Trunk <br /> Type Permit: G. <br /> Lateral <br /> Remarks: Abutting Lot Line <br /> N, S, E, W ft. <br /> � <br /> i � <br /> — APProved By �i � � � i �i %�� <br /> City Engineer <br /> IMPORTANT! , L � <br /> Issued By �i'i !_,�_:,�1" `'_ .:lt �.,_i.� <br /> CALL 1-800-424-5555 48•HOURS � <br /> PRIOR TO DIGGING . <br /> CALL 259-8811 FOR INSPECTION /,� <br /> Inspection By U� <br /> Date �nspected ��� � <br /> SEE SKETCH ATTACHED No. 2585� <br /> ir.����c�ior�� <br />