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� <br /> . CHART NO. <br /> evereri <br /> � � c�f� Yf 3 o�a4 <br /> � <br /> City of Everett <br /> �evver Application and F'ermit <br /> No. 25966 DATE � �'' � <br /> /1 � <br /> Service Address ..�,��//—,���F'e����� Utifity Account No.._ � <br /> , c � � ) !-- <br /> --- -- v fl I'MP � Permit Fee <br /> Billing Address_ , - - <br /> City,State, Zip <br /> Connection Charge(s) , <br /> j i . �.� Total Fee ��' <br /> pwner (Morigagor)� ,; �' '' � - - <br /> Billing Name � <br /> � � ' ii;t3/tic� 7.1.=1Liai 11�JC4it}?S:5 1:i��Y <br /> Connection By - -- � <br /> . i ` Signed LHMx+�4;,�--�- <br /> Address — �����,f� gl�.pp <br /> � <br /> �.,,, , — „ c�c�t; aao.rro <br /> Phone <br /> DESCRIPTION: Se��er District <br /> Lot Block Monthly Sewer Service <br /> Plat__ <br /> Unplatted Description Monthly Se��er Constr. <br /> Trunk <br /> Type Permit: r f <br /> Lateral <br /> -I Remarks: qbutting Lot Line <br /> N, S, E, W ft. <br /> � <br /> _ Approved By ���y Engineer <br /> iMPORTANT! Issued By <br /> CALL 1-600-024•5555 48-HOURS <br /> I PRIOR TO DIGGING <br /> I CALL 259�8871 FOR �NSPEC?ION <br /> Inspection By — <br /> Datelnspected — <br /> SEE SKETCH ATTACHED <br /> No. 2596� <br /> INSPECTION <br />