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( CHART NO. <br /> evered - ` <br /> � <br /> City of Everott <br /> � <br /> Sewer Application and Permit ' <br /> N0. �`� 'Jr8 I DATE �►Psil �. 1996 <br /> y8 3s� <br /> Service Address �« �i��O°d �~ Utility Account No. <br /> Billing Address ���9 �ar Permit Fee �•� — <br /> City,State, Zip Ms'�te, N)1 9l201 Connection Charge�s) � 270.00 <br /> Ow�er (Mortgagor) �� ��tt Din Total Fee �'�� <br /> Billing Neme �O�rt-�� ��1 =N�� osdi°�ncv 1171-85� <br /> x.a: us.00 <br /> Connection By D•G. �O� CO� �r �.� <br /> SS2.00 <br /> Adtlreu S]07 - 139Lh Aw Suoho�l�A 95490 Signed <br /> cu:�onxr <br /> Phone �� 568-9]12 <br /> DESCRIPTION: Sewer District II <br /> Lot C Block <br /> Monthly Sewer Service <br /> Plat �i+rtt-n�.■± sp �-36-�-a <br /> Unplatted Description Monthly Sewer Constr. <br /> Trunk <br /> Type Permit: tuw Qonn�oeion <br /> Lateral <br /> Remarkr. r�s5'w� u.- Nies �Pd�oCs <br /> 1 I Abutting Lot Line <br /> �►�sd+U ..9 t-i ��o�+�� � �t N, S, E, W ft. <br /> ) GG� w� /� µe�� O ..- f�.rrC w{—' <br /> 1,ews� l.00k -� <br /> � Approved By � R Tt�' <br /> � City Enqineer <br /> IMPORTANT! ��t �y�� <br /> Issued By <br /> CA L L 1 SOOd24•5555 48-HOU RS <br /> PRIOR TO DIGGING <br /> CALL 2595811 FOR INSPECTION <br /> � Inspection By <br /> IDate I nspected <br /> SEE SKETCH ATTACHED Np, Z5rJ8T <br /> IN�PECTIGN <br />