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de <br />City of Everett <br />Sewer Application and Permit <br />NO. 25114 DATE gray 1ee 7 <br />Service Address ei123 R a 1 riyiaq sueet <br />Billing Address T.C. am ils <br />City, State, Zip >r eioral", ft. 98290 <br />Owner (Mortgagorl'7L ae leedlti <br />Bii.'ng Name lee <br />Connection By — <br />56*4301 <br />DESCRIPTION: <br />"Lot 2 Block 6 <br />Plat leeesli tills Div. i4 <br />Unplatted Description <br />Tvoe Permit: tnowen eeaeeati <br />SEE SKETCH ATTACHED <br />, <br />0 <br />Utility Account No. <br />Permit Fee 30.00 <br />Connection Charge(s) <br />22020 6".20 <br />Total Fee 30.00 <br />Oedinamn 98M83 <br />1161.00 <br />Signed <br />Customer � <br />Sewer District land 1 <br />Monthly Sewer Service <br />Metered <br />Monthly Sewer Constr. <br />Trunk 116.So <br />\ INSPECTION <br />Lateral <br />522.40 <br />Abutting Lot Line 80 <br />N S, E !W- " _ ft. <br />Approved By A. R. T real <br />City Engineer. <br />Issued By R' to r3 <br />Inspection By 4!; <br />Date Inspected r 3o-€r- <br />NO. 25114 <br />