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— CHART N0. <br /> everett � <br /> i <br /> I <br /> � I <br /> City of Everett �I <br /> Sew�er Applicati�n and P�errnit <br /> � <br /> No. 25387 DATE r �_ i <br /> Service Address Utility Account No. � <br /> Billing Address . Permit Fee , i <br /> i <br /> City, State, Zip Connection Charge(s) . ' <br /> I <br /> Owner (Mortgagor) Total Fee _ <br /> Billing Name 8e�aer Dev. Feo Ord 1171-85 i <br /> Water — 960.00 I <br /> Connection By Sexer —1212.00 � <br /> i � .672.00 <br /> f + <br /> Address Signed U�' . — ��"'`�"' _ � <br /> � CuStOmer � <br /> Phone <br /> DESCRIPTION: Sewer District <br /> Lot ^g^ Block }a Monthly Sewer Service <br /> Plat <br /> Unplatted Description Monthly Sewer Constr. � <br /> Trunk <br /> Type Permit: xnv con���`►��+* <br /> Lateral <br /> Remarks: <br /> Abutting Lot Line <br /> N g E, W ft. <br /> i <br /> � <br /> � <br /> Approved By — <br /> c�cv nq� r.r <br /> IMPORTANT! <br /> Issued By <br /> CALL 1-800-424-5555 48-HOURS ' <br /> PRIOR TO DIGGING <br /> CALL 259�8817 POR WSPECTION ;% i <br /> InspectionBy ��( C�''`���L-�'"` - <br /> Date Inspected z �7 �� ��� \ I <br /> SEE SKETCH ATTACHEI� ND• �`'�'j� � li <br /> Ii.._. _ ,1it�i ; j <br />