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evereri <br />e <br />City of Everett <br />Sewer <br />� <br />� ������ <br />p{('� m.-:��p <br />l�l G Y% VY M ti lN <br />s7 wT Nr M M <br />W � ili � <br />Ap�l�ati c <br />� ������������ <br />No. 25713 � DATE ,���� •e.� <br />Service llddress <br />BillingAddress uj�����p� ��) ya� <br />City, State, Zip ��.,gg� <br />Owner (Mortyagor) —�� r.••-- -- s <br />Billing Name <br />Connection <br />Phone <br />CHART <br />SE,✓r To as�.v,er••rG <br />S /� —B7 <br />Utility Account No. <br />Permit Fee ���... <br />Connection Charge�s) <br />Total Fee <br />Speclal SeMer Fae� OM. 1171-85 <br />Mater 471.00 <br />Signed � � <br />� cust r / <br />/ <br />DESCRIPTION: Sewer District <br />Lot__�_Q__-- Block <br />Plat Monthly Sewer Service <br />Unplatted Description Monthly Sewer Constr. <br />Type Permit: <br />Remarks: <br />IMPORTANTI <br />CALL 1-800�424•5555 48•HOURS <br />PRIOR TO DIGGING <br />CALL 259�8811 FOR INSPECTION <br />SEE SKETCH ATTACHED <br />Lateral <br />Abutting Lot Line <br />N, S, E, W. <br />Approved By <br />pineer <br />Issued By S. "------ <br />Inspection <br />Date I <br />INSP[CTICf�I <br />.�— 2— �' <br />No. 25713 <br />