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everefl <br />e <br />City of Everett <br />S�wer Application and Permit <br />NO. 26�51 DATE ��ua�y 30, 1987 <br />Service Address 4992 1lerar tt_ Utility Account <br />Rilling Address 1061 3o+A o. c E <br />City, State, Zip FrK�tt_ Y� ORfQ� <br />Owner (Mortgagor) Sthr�e Ba�py <br />Billing Name � <br />Connection By y� — <br />Address 10612 ��h 11r_ e g <br />Phone '��7-��Q <br />DESCRIPTION: <br />Lot � Block <br />Plat Ed$••M* <br />Unplatted Description <br />Type Permit: <br />Remarks: <br />IMPORTANT! <br />CALL 1500�424-5555 48•HOURS <br />PRIOR TO DIGGING <br />CALL259S811FORINSPECTION <br />SEESKETCH ATTACHED <br />CHART <br />5��.��i ?a CNAFTialC.- 7-2j-�7 <br />Permit Fee 30_DO <br />Connection Charge(s) <br />Total Fee 30 00 <br />Speclal Utillty Fe! Ord, 1171-85 <br />Mater 224.OD <br />1 i <br />Signed ,(� , ^ `;'��%�� <br />/ ca:con,cr <br />Sewer District Bond i2 <br />Monthly Sewer <br />Monthly Sewer Constr. <br />Lateral <br />Abutting Lot Line <br />N, S, E, W <br />Ik'f0��t;7 1U:4:�AH 1100A113832 �kCt <br />Approved By_p� � �r�q°�7'y� <br />�Engine4�j�— <br />F��� '�4.Q.� <br />Issued By� cn �iaug�qCS:i.W <br />E: SFCN 37.Sfi <br />[ 5R1:N �75.U� <br />DF`VW'1 / d:.''O.OU <br />��» r �,, �°� Y <br />Inspection By ���'�3"Y — <br />'�?1:LAF' l36.[A] <br />Date I nspected � � � � �+��� <br />�;���: 3���1'�051 <br />NU. <br />I NSPGCTI Of�J <br />