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everen <br />� <br />City of Everett <br />Sewer Application and Permit <br />No. 26315 DATE ��•�•t sa�i�e� <br />Service Address <br />Billing Address <br />City, State, Zip <br />Owner (Mortgagor) , <br />Billing Name <br />Connection By <br />Address <br />Phone <br />Utility Account No. <br />Permit Fee ie ne <br />Connection Charge(s) <br />Total Fee 1e eo <br />Signed <br />cu:�omcr <br />DESCRIPTION: Sewer District <br />Lot Block Monthly Sewer Service <br />Plat <br />Unplatted Description Monthly Sewei Constr. <br />Type Permit: <br />Remarks: <br />w �— <br />IMPORTANTI <br />CALL 1�800-024•555548•HOURS <br />PRIOR TO DIGGING <br />CALL259S811FORINSPECTION <br />SEE SKETCH ATTACHED <br />Abutting Lot Line <br />N, S, E, W. <br />Approved By use4n j} �u, <br />City Enpinen <br />ft. <br />118,''�ylli7 .^.�t�i'ti lklt��M/�i7'� {'if.i <br />Issued By s�L}.;:uq�a <br />4fl�hl".6� 15 <br />��1JER .10.(nl <br />I;�:L}: ', 3� <br />Inspection By <br />��/ <br />Date Insp:cted ��G `� 7 <br />No. 26315 <br />I f�!SPGC?ION <br />