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City of Everett <br />Sewer Application and Permit <br />N0. <br />�� j J' DATE _March 26 1986 <br />ServiceAddress 3�2a Hoyt /¢Ve- <br />Billing Address <br />City, State, Zip — <br />Owner (Mortgagor) <br />Bill��g Name <br />Connection By ��ty of Everett <br />Address <br />DESCRIPTION: <br />Lot BI <br />Plat �— <br />Unplatted Description_ <br />Type Permit: Repair <br />Remarks: <br />in�PORraNr! <br />CALL 1�500-424-5555 48�HOURS <br />PRIOR TO DIGGING <br />CALL 255-8611 FOR INSPECTION <br />SEE: SKETCH ATTACHED <br />CHART N0. — � <br />:, _-:��, <br />Utility Account No. <br />Permit Fee_ Nore <br />Connection Chargels) <br />Total Fee_ None <br />Si�ned Don Miller <br />Cusiomer <br />Sewer District -- <br />Monthly Sewer Service_ <br />Monthly Sewer Constr. <br />g Lot Line <br />N, S, E, W <br />App�OVCd BY ���� Engineer <br />I ssu ed <br />ft. <br />7 . , ,� � <br />InspectionBy =f� �����`'` — <br />Datelnspec2ed��=' �� <br />NO. , � <br />CUSTOiv7CR COPY <br />