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CHART N0. <br /> everett . • ' <br /> F �S-?.R-5 <br /> � .� <br /> City of Everett $ � � �,•; � ;:; $ ;� 3 � � _ �Fy>To cli.a,��:.�i- <br /> -- �� q �� .;: .: :ri q ,c�+ r� ' 3 _3- A7 <br /> j[I Y C 1 .r H. .y ti �� _ _ <br /> p? t? W tl� �� W 1F l <br /> Sewer �4pplic�ation ari=l� Pexmit �; � �� :� i� �� <br /> \ � V 'J �l � CJ ;a� ^� 1 C I ii ._ <br /> �'i i "� " <br /> :.: �� � � � .^_' � �. s� �' [ � ';- :.. <br /> 25926 . . � � � =� � � � � _ <br /> > ':: i� L � r' � _s .. �.. +-' _" �� .�' <br /> N0. DATE �.�— <br /> Service Address Utility Account No. <br /> BillingAddress q��� L��e PermitFee _ <br /> City,State, Zip_�r_ ` Connection Charge�s) <br /> Owner (Mortgagor) Total Fee <br /> BillingName Special Utillty Charge Of'd. 1171-8!' <br /> �eme-- water 152.Q0 <br /> Serer 400.00 <br /> Connection By _ �2-0� <br /> Address Signed � ' <br /> -- Customer <br /> Phone_ <br /> DESCRIP710N: Sewer District <br /> Lot��_ Block_�— <br /> Piat nt�oh����r ni�R Monthly Sewer Service <br /> Unplatted Description _ _ Monthly Sewer Constr. <br /> Trunk <br /> Type Permic: Nev connection - • <br /> Lateral <br /> Remarks: <br /> Abutting Lot Line <br /> N, S, E, W ft. <br /> — Approved By A7 Th nl <br /> Gry Englnccr <br /> IMPORTANT! <br /> Issued By�a;,;,s� <br /> CALL 7$00-02A-555548�HOURS <br /> PRIOR TO DIGGING <br /> CALL 259�8811 FOR INSPECTION , <br /> Inspection By � � <br /> Date I nspected �Z'�«/ <br /> SEE SKETCH ATTACHED NO. ����� <br /> li�." . � !(��`��i <br />