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�� <br /> tl' <br /> r'! <br /> �, • <br /> CHART N0. ���3"��� <br /> everet8 <br /> � �jS{Cd <br /> City of Everett �'�'�' <br /> �'- 3/��P <br /> Sewrer �►ppiication and P�rmit � <br /> Januazy 24, 1984 <br /> r�o. �4731 DATE <br /> 76327-�� <br /> 12S East Intercity Avenue Utility Account No. - <br /> Servire Address <br /> 30.00 I <br /> I�.p. Box 5�08 permit Fee <br /> Billina Ad�irP;s --- <br /> Eoerett, ►Ia. 98706 330.00 <br /> City, State, Zip __ Connection Charge�sl— — <br /> 30.00 <br /> Owner (Mortgagor) ��4� �'velopment Total Fee_ - <br /> ordinance 722-DO <br /> Billing Name - 7��8 Z �w�A� paid <br /> Connectian By I <br /> Signed <br /> Address Cusvmer <br /> Phone ;3'�-5016 <br /> DESCRIPTION: <br /> Sewer District_ �ad III _ <br /> Lot_� Block G.50 _ I <br /> Plat <br /> Intercity Park Monthly Se�!ver Service , <br /> Unplatted Description Monthly Sewer Constr. <br /> Trunk 330.00 <br /> Type Permit: New Connection <br /> Lateral I <br /> Remark;: Abutting Lot Line <br /> N, S, E, N/ - ft• ��I <br /> I <br /> A. R. Theal � <br /> Approved By <br /> Ciry En�inccr � <br /> E. eond <br /> - Issued By � <br /> — � r � <br /> I Ins ection By�.�- `� I <br /> P <br /> Date Inspected � �� � <br /> ISEE SKETCH ATTACHED N�� 2�i�+71 II <br /> i <br /> IN;PLCi�ION <br /> �t <br />