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everett <br />� <br />, City of Everett <br />Se�nrer Appli�ati <br />No. 26294 <br />Y <br />� <br />! �:� � � ^ <br />_ _ e; <br />— — ^, � ! � O r� <br />� i- � .w r-! 'v7 <br />. . [r <br />:� <br />'on and P�i�iiit = ; <br />ti � � L <br />_7 Y.z4:_���- <br />� s {? ,-� ''= = J `= <br />� _- _- <br />DATE a�,m,ar z, �aa� <br />Service Address 3222 Hovt Ave <br />Billing Address ��+M <br />City, State, Zip everett. wa 90201 <br />Owner (Mortgagor) r.nneth naBoar <br />Billing Name s�z sane _ <br />IConnection Bv <br />Phone �So-5aas <br />DESCRIPTION: <br />Lot Z1'z2 <br />Plat �* xaaratt <br />Unplatted Descriptio <br />Type Permit: Al <br />Remarks: Convera <br />is to be a G" <br />Block 76`� <br />IMPORTANT! <br />aewer to <br />CA L L 1 E00-024-5555 48-HO U R S <br />PRIOR TO DIGGING <br />CALL 259�8811 FOR INSPECTION <br />SEE SKETCH ATTACHED <br />CHART N0. <br />� , =/, ' ---'r <br />j O � <br />OfjY� <br />W :.. C`� <br />� R <br />Utility Account No. <br />Permit Fee yp,r:� <br />Connection Charge�s) <br />Total Fee ,n n <br />special Utility Pee, ozd <br />water 122.00 <br />aeaar 320.00 <br />422,00 <br />Signed <br />'� -'' ,= � <br />1171-85: <br />Sewer District — <br />Monthly Sewer <br />Monthly Sewer Constr. <br />Lacera <br />Abutting Lot Line <br />N, S, E, W. <br />qpprrved By �'�D R. 17iE11I. <br />Ciry Engincer <br />Issued By �48=et E. NcLeod <br />Inspection By -�` <br />Date I nspected �' �" �� <br />N0. 2629� <br />�� "�P�i:'i 10f'J <br />