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evereri <br />e <br />City of Evr,•rett <br />,� <br />G <br />�J <br />Q p p p c <br />- G' J�IO CRCO <br />� � f4P� d.�J� <br />� � � � w � a <br />[i M <br />! Sewer Application �n�d �Jerr�t x <br />� � `�v7� ?.�, V ;�, � V <br />NO 27746 DATE� ���� 1 90 �� <br />� Service Address <br />Billing Address <br />City, State, Zip_�� <br />Owner (Mortgagor) , <br />Billing Name <br />(;HART N <br />.5 C n /� 7� �Q� i� % /.5� 'q/ <br />Utility Account No. <br />Permit Fee_� _ <br />Connection Chargels) <br />Total Fee_�U <br />Connection By , ; <br />Signed c ( , c c.._-. : � , ,:.�.i" i.: ' � J <br />Address a:co�� <br />Phone —" <br />DESCRIPTION: Sewer District <br />Lot Block Monthly Sewer Service <br />Plat <br />Unplatted Description_ _ Monthly Sewer Constr. <br />Trunk _ <br />Permit: <br />Remarks: <br />h <br />IMPORTANT! <br />CAI.L �-SC�-424-5555 46-HOURS <br />PRIOR TO DIGGING <br />Lateral <br />Abutting Lot Line <br />N,S,E,W <br />Approved By <br />� <br />Issued By G�Ry ��A q <br />Cf.LL 259-8810 FOF, INSPECTIO� <br />I nspection <br />SEE SKE'!CH ATTACHED <br />Date Inspected <br />No. 27�46 <br />I�SPECTION <br />