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evereH <br />%e m <br />CHy of Everett'' <br />o <br />Sewer Application and Pei <br />NO. 26432 DATE <br />Service Address 2791 •.e.r-` Utility Account <br />Billing Address <br />City, State, Zip <br />CHART NO. <br />Dnv <br />49 <br />4M <br />Permit Fee 10.00 <br />Connection Charge(s) <br />Dwner (MOrtgagOr) rel.watnw fatret wwl <br />Total Fee 10.00 <br />Billing Name ■ <br />Connection By_ <br />Address <br />Phone <br />DESCRIPTION: <br />Lot 15-16 Block 619 <br />Plat Eye*:ee My c — <br />Unplatted Gesc: iption <br />Signed Customer " <br />Sewer D <br />Moiahly Sewer Service <br />Monthly Sewer Constr. <br />..--_.__ <br />Y� <br />Remarks: <br />IMPORTANT! <br />CALL 1-800.424-5555 48-HOURS <br />PRIOR TO DIGGING <br />CALL 259-8811 FOR INSPECTION <br />SEE SKETCH ATTACHED <br />Abutting Lot Line <br />N, S, E, W <br />Approved By EEESR0 ALPRED R. TEEAL <br />City Engineer <br />Issued By Suey Haugen <br />Inspection by <br />Date Inspected Z Si <br />No. 26432 <br />INSPECTION <br />