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everett <br />� <br />City of Everett <br />S�wer Application and P�rmit <br />No. 2�153 <br />DATF June 18, 1385 <br />Service Address ?7I1 iawer Ridqe Road _ <br />Billing Address e East Ftarjtlyn Avenua _ <br />Evernt'�, F9a. 98204 <br />City, State, Zip <br />Owner (Mortgagor) Firstllne Conatruction <br />Billing Name <br />Connection By <br />CHART IVO <br />� B w� �� �as'�, r''� <br />fS �t (p --�� <br />Utility Account No. <br />Permit Fee 30.00 <br />Connection Chargefs)_ <br />Tota� Fee__ �0.00 <br />Ordinance Q1 �9Q4-83 <br />110.04 <br />:I� � � 7 <br />Address Signed ' <br />Customcr <br />Phone 353-1177 <br />DESCRIPTION: Sewer District___ �On� _ <br />Lot 40 Bloc ._ G.50 <br />Plat Cedar Itidge �etatAn _ Nionthly Sewer Service <br />Unplatted Description _ Monthly SeH-er Constr. <br />11�J.00 <br />Type Permit: uev Connectinn <br />SEESKETCH ATTACHED <br />� IW5PECTION <br />Abut[ing Lot Line <br />N, S, E, W. <br />Approved By_ <br />R. n. Theal <br />Ciry EnBineer <br />£. itOP3 <br />Issued Bv __ — <br />Inspection �.��� �'�/MQ'� _ <br />D�te ! �teNected % - � � � — <br />No. 25153 <br />