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everen <br />e <br />City of Evarett <br />Sewer Application and Permit <br />N0. 27187 DATE �iy z1. 19e9 <br />Service Address 6531 llaiw <br />Billing Address <br />City, State, Zip_ ��rt• �► 9Y�0] <br />Owner (Mortgagor) 1�1� J• Lw�itt <br />Billing Name �+�+ <br />Connection 8y � <br />Address � <br />Pnone sss—oaoa <br />DESCRIPTION: <br />Lot �� .�_� ��.+. Block <br />Plat �lr IIill� Di� 3 <br />Unpletted <br />Type Permit: <br />Remarks: <br />IMPORTANT! <br />CALL 1-600424•5555 48•KOURS <br />PRIOR TO DIGGING <br />CALL259$811FORINSPECTION <br />SEESKETCH ATTACHED <br />Utility Account Na._ <br />Permit Fee 2.50 <br />Connection Chas�ge(s) <br />Total Fee— 2.50 <br />. �' _ . <br />Signed_ � c< < — - ��'r-„�'- �j'(`i� <br />cuyton}er <br />L / <br />Sewer District <br />Monthly Sewer Service <br />US/�bif39 11:40flM fX1QAM5462 LCYi <br />Monthly Sewer Constr. � <br />ifCnk7�71t37 <br />Trunk `�EWL"k x2.5q <br />IiUqO.'_?260 <br />Lateral L` �f:H 53.50 <br />C �iSFI 56.00 <br />Abutting Lot Line <br />N, S, E, W. <br />Approved By �r.�nan a_ �xr�y <br />City Engineer <br />Issued By Susy Aaaa�a <br />Inspection <br />Date I <br />INSPEC710N <br />rvo. 27187 <br />