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i <br /> I <br /> r ' `1 ,' ' CHART NO. =� IZ '2�'o � <br /> -, � <br /> everett ' `� � <br /> e �p�r� 4-,a-g, <br /> City of Everett � �';� <br /> . . � � <br /> Sewer Ap�hcation and Permit <br /> No. 23883 DATE <br /> zi5ia� <br /> 8121 Saet clen Drive 7Go4o-5 <br /> Service Address Utility Account No. <br /> P.O. Box 2343 30.00 <br /> Billing Address Permit Fee <br /> Evcratt, Wa. 98203 110. 00 <br /> City, State, Zip Connection Charge(s) <br /> Robart W• Lundquist 30.00 <br /> Owner (Mortgagorl Total Fee <br /> Robezt N. Lundqaist Ordinanca # G69-80 <br /> Billing Name �=ea I 221.00 <br /> Rohert W. I,uadquiat <br /> Connection By ---- <br /> Address Signed c�:�om�� <br /> 355-7902 <br /> Phone <br /> � 6 Dond I <br /> DESCRIPTION: Sewer District <br /> � Lot B Block 5. 10 <br /> Evergreen Glea Monthly Sewer Service <br /> Plat — <br /> � Unplatted Description Monthly Sewer Constr. <br /> 0.20 110.00 <br /> Trunk I <br /> Type Permit: New Connectioa I <br /> Lateral I <br /> I <br /> Remarks: Abutting Lot Line i <br /> N� g, E, VU ft. <br /> � <br /> x. noushey <br /> Approved By <br /> Ciry Enginccr <br /> I I;. IIond <br /> — Issued By <br /> — Inspection By�� �-� "�`"�" I <br /> Date I nspected -� - � �'" � � <br /> SEE SKETCH ATTACHEQ N�• Z3S�3 '� <br /> I <br /> I <br /> INSP[:C11UN I <br />