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everett <br />e <br />City of Everett <br />Sewer Application and Permit <br />CHART <br />N0. ZTOST DATE *.s...... � <br />4r--2&. 19Y9 <br />Savice Address � Utility Account No. <br />Blilinp Address .++. y�y�,��r� <br />Gty, State, Zip_�� <br />Permit Fee z tn <br />Connection Charge�s) <br />Owne► (Mortgagor) Total <br />8illing Name �w <br />Connection By <br />Address � <br />Phone <br />DESCRIPTION: <br />Lot_ lt Block-6�7 <br />Signed <br />Customer <br />Sewer D <br />��=-t� T 'rc> i-c,�-ini4 <br />!i- iG-e.�1 <br />Plat Monthly Sewer Service � j°4`��� �'`�"�u �Y�t <br />—iws�tt aL� C <br />Unplatted Description fllD0�171Q <br />Monthly Sewer Con�r�,�� �.�.� <br />Type Permit: Trunk ���171�� <br />Laterel ��t?`� . <br />Remarks: ,r ����'+�-� <br />t!(�711c^ i p69 <br />Abutting Lot Lineg�ryE�. ��.�-�y <br />� N, S, E, WJ'OtkT�'BS�€' ft. <br />� SIi�G: b2.:�) <br />�� (+�'A(�'O'rp�i i f�}7 f (, <br />0 � .71.lN.�\ Y[.�CN <br />(���li ��.�.t� <br />� Approved By �D R. TAEAL <br />City Enpineer <br />IMPORTANT! <br />CA L L 1�800-024•5555 48-HOURS <br />PRIOH TO DIGGING <br />CALL 259-SB11 FOR INSPECTION <br />�� <br />SEE SKETCH ATTACHED <br />issued By Snsy HauqQa <br />Inspection <br />Date I <br />IAlSPECTION <br />NO. 27007 <br />