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CHART NO. <br />evered <br />e <br />City of Everett <br />_� -2 <br />Sewer Application and Permit <br />No. 27000 DATE 5- ►) - 89 L- <br />Service Address 314 '� 4 Fe n e-r A Ale— Utility Account No. <br />Billing Address <br />City, State, <br />Owner (Mortgagor) <br />Billing Name <br />Connection By C- 1+%j O F F \1P Y-e-1 t <br />Address <br />(itr <br />DESCRIPTION: <br />Lot Block <br />Plat <br />Permit <br />Connection Charge( <br />Total <br />Signed <br />customer <br />Sewer D <br />Monthly Sewer <br />Unplatted Description Monthly Sewer Constr. <br />type rermtt: <br />Remarks: <br />' a od Tf! <br />'D. <br />s PL C) ' 'D t <br />IMPORTANTI <br />CALL 1-800.424-5555 48-HOURS <br />PRIOR TO DIGGING <br />CALL 259.8811 FOR INSPECTION <br />SEE SKETCH ATTACHED <br />Lateral <br />Abutting Lot Line <br />N, S, E, W ft. <br />Approved By <br />- City Engineer <br />W <br />Issued By T%aN M I S le Y <br />14 <br />Inspection By <br />Date Inspected <br />No. 27000 <br />CUSTOMER COPY <br />