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CHART <br />everett <br />City of Everett <br />Sewer Application and Permit <br />NO. 25480 DATE a <br />Service <br />Billing <br />City, S <br />Owner <br />Billing <br />Connection <br />Address <br />Phone <br />DESCRIPTION: <br />..SEtiT <br />% Gr/o�tTir/G <br />S =is -gG <br />Utility Account No. <br />Permit Fee 30Ofl- <br />Connection <br />di <br />Total Fee 3� <br />(%�st /1-71' 4� <br />yd d <br />Signed <br />Customer <br />Sewer <br />Lot Block <br />Monthly Sewer Service <br />Plat <br />Unplatted Description__ 3) - 12 i — Monthly Sewer Constr. <br />Type Permit: ,' �`/ Trunk <br />Lateral <br />Remarks: <br />Abutting Lot Line <br />N, S, E, W . ft. <br />Approved By (i! <br />C-ty Engineer <br />IMPORTANT! <br />CALL 1.800-424.5555 48-HOURS Issued By <br />PRIOR TO DIGGING 1 <br />CALL 259-8811 FOR INSPECTION <br />Inspection By IlLur " <br />Date inspected 3"!�— 6G <br />SEE SKETCH ATTACHED No. 25480 <br />INSPECTION <br />