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everett <br />e <br />City �n Everett <br />Sewer Applica�'ion and Permit <br />CHART NO. <br />s•c,r.— rc� rHP.�,-,,:iU 9��-y/BG <br />No. 2553T DATE anzil i�, lo� � <br />Service Address 22� ��� Utility Account No. <br />BillingAddress �Zl 8t Ewsrtt M�11 tta9 <br />City, State, Zip ��ti, 1� Ytlt 9820t <br />Owner (Mortgagor) � �liv <br />Billing Name $+� <br />Connection By ��n �nt�uation __ <br />Address u16 Lks St�we� 11d.. Evrrst! _98205 <br />Phone 7�13-3tt8 _ <br />Permit Fee <br />Connection Charge(s) TZn_m <br />Total Fee <br />Sp�oial taes, Ordinaoa� 21�1-SS <br />Maeer 179.00 <br />8wier �71.00 <br />650.00 <br />Signed <br />cu:tomer <br />DESCRIPTION: Se•Ner District <br />Lot u-�4 Block » <br />Monthly Sewer Service <br />Dlot ,--- � " —' � — .� ,.'-- — <br />I I....InH�J n�...;........ _ _ _ Monthly Sewer Constr. <br />". . <br />Type Permit: <br />Remarks: <br />IMPORTAN7! <br />CALL 1-SOOd24-555548•HOURS <br />PRIOR TO DIGGING <br />CALL 259-8871 FOR INSPECTION <br />SEE SKETCH ATTAI'.HED <br />Abutting Lot Line <br />N, S, E, W. <br />Approved By Nd'R�D R S'�L <br />City EnBineer <br />Issued By <br />�� i � <br />Inspection � <br />Datelnspected 'f-�9 �G <br />No. 25597 <br />INSP[CTfON <br />