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everen <br />e <br />City of Everett <br />� <br />� <br />��s� <br />�,-�-�, o .[..:� o ;n <br />� i! Y. W M <br />t9. <br />Sewer Application and P��it � � � <br />" ������� <br />NO. 267Z5 DATE �'� �- <br />Service Address �' — <br />Billing Address , <br />City, State, Zip ■ ' "' ~M� — <br />Owner (Mortgagor) '' ""'��"'!� <br />Billing Name � <br />Connection By <br />Address <br />Phone �' w "�� <br />Utility Account No. <br />Permit Fee le m <br />Connection Charge�s) <br />Total Fee 10 eo <br />`, <br />� :' <br />�� <br />Sig�ed '� cusrome. <br />DESCRIPTION: Sewer District <br />Lot B��k Monthly Sewer Service <br />Plat <br />Unplatted Description _ Monthly Sewer Constr. <br />Typa Permit: <br />Remarks: <br />% <br />5 �,`� • _ <br />N� I � �PORTANTI <br />CALL 1-800�424•5555 48-HOUflS <br />PRIOR TO DIGGING <br />CALL 2fi9-8811 FOR <br />SEE SKETCH ATTACHED <br />Lateral <br />Abutting Lot Line <br />N, S, E, W <br />Approved By c cv�'"'�'L <br />�ssued By "-� ��'�ie - <br />Inspection <br />Date I nspected <br />Na. 26725 <br />INSPECTION <br />