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CHART NO. <br /> e��rett <br /> e� <br /> SENT To CNAe;i,dG ]�3 47 <br /> / <br /> City of Everett <br /> Sewei� A�phcc�tio� and Permit <br /> NQ, Z6OZO DATE .7�rwa�y 11, 1987 _ <br /> Service Address Utility Account No. _ <br /> Billing Address Permit Fee <br /> City,State, Zip Connection Charge(s) <br /> Owner (Mortgagor) , Total Fee <br /> Billing Name special utillty tee ordl�ance 1271-65 <br /> water 224.Q0 <br /> Connection By ' <br /> � � . ==/i�`�.� <br /> Address Signed -'/// •" / il�i <br /> � � � Customer <br /> Phone_ _ <br /> DESCRIPTION: Sewer District�� <br /> Lot_�_ Block Monthly Sewer Service <br /> Plat �y estwou' <br /> Unplatted Description Monthly Sewer Constr. <br /> Type Permit: Trunk <br /> Lateral <br /> Remarks: <br /> Abutting Lot Line <br /> N, S, E, W ft. <br /> Approved By <br /> �fo <br /> IMPORTANT! <br /> CALL 1$00-024-555548•HOURS ISSUBd By <br /> PRIOR TO DIGGING <br /> CALL 2595811 FOR INSPECTION //J <br /> /� <br /> Inspection By �7��� - <br /> Date InspecttJ �- s�7 <br /> SEE SKETCH ATTACHED N0. ZSOZO <br /> IN�PECTION <br />