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everen � <br />e � <br />� <br />City of Everett ?; <br />fj. <br />b <br />Sewer Application an <br />�f n � <br />N0. L625L DATE _ <br />CHART <br />s <br />� <br />� <br />4�.�J Vl � <br />Ll {ii {4{ <br />Service Address 306 SY Pv�r�tL nali T�iay-- <br />Billing Address �--- <br />(�,Ity, State, ZIP �—.��• m�. neana <br />Owner (Mortgagor) yq�+_,.. <br />Billing Name �� <br />Connection By_�����_ <br />Address p,� � �t�g ����_ <br />DESCRIPTION: <br />Lot Block <br />Plat <br />Unplatted Descript�on <br />Type Permit: � ��� <br />Remarks: ( � an/� ✓�n in <br />.ti <br />%-Z� ��1 <br />�`C(AM f� <br />IMPORTANT! <br />CALL 1800-024•5555 48•HOURS <br />PRIOR TO DIGGING <br />CALL 259�8811 FOR INSPECTION <br />SEE SKETCH ATi'ACFiED <br />Utility Account <br />� a� � gu�','g �� <br />�j p o4 <br />if� tR iWrol^.. N� G� � A efr ; <br />W <br />c m � �, <br />g M <br />� i,a� �� y�~ � J� � ��{y�C��- <br />M o <br />�SSIiLL� � �::J tDf1i G.. (11 r�t <br />Permit Fee 3g R.. <br />Connection Charge�s) <br />Total Fee �..... <br />3pocial Otility Pee Qord. 1171.—BS <br />vnter 2ZE2ZEY vater 33.61 <br />7CX ae�er @8.60 <br />L22.i1 <br />Signed <br />Cusromer <br />Sewer District <br />Monthly Sewer Service <br />Monthly Sewer Constr. <br />Trunk <br />Abutting Lot Line <br />N, S, E, W ft. <br />Approved By 1u.t':t&D R. 1ttF.Ar. <br />City Engineer <br />Issued By Suav Hanann <br />Inspection <br />I NSPECTION <br />Inspected � <br />uo. �6252 <br />