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everett <br />e� <br />¢ <br />C.li�/ Of EVBfBii � S ."'� `L'�'S � "�1' <br />� � ° � .�i � <br />H• � R �T , � <br />Sewer A� ic�`�d� <br />� � ^- � c_ <br />2%s8� �Sm�.--��.� <br />N0. DATE <br />$ervice Address 5215 iast 6�r <br />CHART N <br />�in� � ��r�,� g-(2-4/ <br />Billing Address �+ +--�;,qy <br />City, State, Zip _ <br />Owner (Mortgagor) u�-"""'^ L''�� R'�" <br />Billing Name �` <br />Connection By <br />DESCRIPTION: <br />Lot 1 Block <br />Plat <br />Unplatted Description <br />Type Permit: <br />Remarks: <br />' � c� v�^ <br />� <br />� .o r �N r � � <br />p T � i � <br />n ' <br />IMPORTANT! �D <br />CALL1-800-024-555548-HOURS 1/a��� <br />PRIOR TO DIGGING <br />CALL 259-8811�FOR INSPFCTION <br />SEESKETCH ATTACHED <br />Utility Account <br />Permit Fee <br />Connection Charge(s) 600.0G <br />Total <br />�RSiICO uil-$S <br />ualar 179.00 <br />..M.: �n. o0 <br />650.00 <br />Signed <br />cu:tomer <br />Sewer District �� * <br />Monthly Sewer Service <br />Monthly Sewer Constr. <br />Trunk nn nn <br />Lateral eon en <br />Abutting Lot Line <br />N,S,E,W <br />Approved By r..nu. rn�nw�� <br />Ciry Engineer <br />155ued By -T n...�ti...�i <br />I�spection <br />Datelnspected <br />No. 27684 <br />INSPECTION <br />