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� <br /> . . <br /> I � �� I CHART N0. <br /> •veret+ <br /> � <br /> City of Everett <br /> 5ewer A�plication and Permit <br /> � <br /> � <br /> �+ H <br /> NO. 250�p DATE j'�ch 28, 19Ei5 �n,., <br /> Service Address ZZZ� I.omt�ar° Utility Account No. <br /> 5606 Ever9reen Way 30.00 H H <br /> Billing ,address_ Permit Fee � y � <br /> H rj <br /> City, State, Zip E�rerett. Wash3u;ton 98203 Connection Charge�s) I � �� <br /> Everett suild+,rs, inc. Totaf Fee 36.00 <br /> Owner (Mortgac,cr) _ <br /> � <br /> Billing Name Ordinance 984-83 800.00 y <br /> �3 <br /> Connection By � :i�,� i; -- % i � ; ._.. � ' l /._% - K� z <br /> Address_ Signed ' J ���i!/1,�' --.^- -�=,, •v—n-v. , � � <br /> Customer ` � <br /> Phone 353-7161 0 � <br /> � <br /> DtSCRIPTION: Sewer District � , <br /> � ot 5 � 12-13 glock 475 ui <br /> Plat ��ezett Monthly Sewer Service � <br /> Unplatted Description Monthly Sewer Constr. �' <br /> Type Permit: Nev Conc:ectioa Trunk � � <br /> _ Lateral � � <br /> P.amarks: <br /> Abutting Lot Line � <br /> N, S, E, W T'}Orthend f� � <br /> � � <br /> A, R. Tbeal <br /> I � <br /> Approved By <br /> Ciry Engineer I <br /> - Issued By E. Bond__ i <br /> � <br /> -- � <br /> Inspection By� ��'� ��""`�H I <br /> __ Date Inspected S��S _ j � <br /> i <br /> SEE S�(ETCH ATTACHED No. 25056 � <br /> INSPECTION <br /> � <br />