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CHART NO. <br />everen <br />e <br />City of Everott <br />��=Tl T �rc� i-'o�'r_iNC� <br />ii_ �v_��, <br />Sewer Applicotion and Permit <br />N0. 27087 DATE � +�- ;� �, 194! � <br />Service Address Utility Account No. <br />Billing Address_µ�� ��+-� -- — — <br />City, State, Zip ��tt� 1A� /�ip3 — <br />Owner (Mortgagor) — <br />Billing Name_,--- — <br />Connection By_.o--- <br />Address � <br />Phone <br />DESCRIPTION: <br />Permit Fee �_Ro <br />Connection Chargels) <br />Total <br />Signed <br />c�m�� <br />Sewer D <br />Lot ls Block 67T MonthlySewerServ�ic�� t�4�'M OODRM46D2 2ttt <br />Plat ■ -• •••_ •• <br />Unplatted Description Monthly Sewer Con6t �i i 18 �3.� <br />Trunk �1719 <br />Typa Permit: ' <br />Lateral �`1?ZO <br />Remarks: <br />f Abutting Lot Line r���� �,?,sp <br />N, S, E, W.pqJ0�N9g h• <br />s[a� i2.so <br />\� a000zroe� sz.:� <br />° ��i►ri;�sc � ii'� <br />Approved By <br />�I c�cv e�o���. <br />IMPORTANTI <br />CALL 1$00424�655548•HOURS <br />PRIOR TO DIGGING <br />CALL259�R'11 FOR INSPECTION <br />�� � <br />SEE SKETCH ATTACHFD <br />Issued By �Y 4��° <br />Inspection By <br />Datelnspected <br />INSPECTION <br />No. 21087 <br />