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• CHART N0._ <br /> evereri � <br /> e � j EN? T�� rH�2i/�/G <br /> � 5- aa -B� <br /> City of Everett z � � ,�'y � L? $ y: $ $ $ $ <br /> , pQ.. <br /> ��� y � Y a.-�+ .-�� J � � � � � O <br /> Sewer Application and P��t A M � .R � � �� � � « <br /> •.* c� " ��p u+ <br /> �i�. " �1 � � � �yJ " ' � p `�j' � <br /> W �+ 4^ w� cz.,1, !J] h 1— y'� 1— y�l <br /> 2�H�S 3Q'I 'LL S� .T. O� W ' 9: J1 � �•• .—�� .� f_+ L <br /> N0. DATE _.�pq�3��f:— <br /> Service Address.�� Utility Account No. <br /> Billing Address Permit Fee � <br /> City,State, Zip Connectic.i Chargels) � _ <br /> Owner (Mortgagor) , Total Fee_ . — <br /> Billing Name 9p�oial thiliey Pae. Osdinanoe 1�71N5 <br /> vabr 179.00 <br /> Connection 8y sw�z . 471.00 <br /> 650.00 <br /> Address Signed _ —��� <br /> cu:tomer�' � <br /> / 1 <br /> Phone �� <br /> DESCRIPTION: Sewer District�— <br /> lot �_ +« Block 7 Monthly Sewer Service <br /> Plat � � <br /> Unplatted Description .... r�d a7�.� Monthly Sewer Constr. <br /> Trunk <br /> Type Permit: <br /> Lateral <br /> Remarks: <br /> Abutting Lot Line <br /> N, S, E, W ft. <br /> Approved By <br /> n <br /> IMPORTANT! <br /> Issued By <br /> CALL 1�800-024•5555 M1S-HOURS � <br /> PRIOR TO DIGGING <br /> CALL 259-8811 FOR INSPECTION <br /> Inspection By—, <� <br /> Date Inspected s��7 <br /> SEE SKETCH ATTACHED No. 25848 <br /> INSP[CTION <br />