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CHART NO. <br /> everett � <br /> �j��v,'T ',� C"r1 A-z�'���- <br /> � � �� <br /> 2,, - � <br /> � <br /> � <br /> City of Cverett I <br /> I <br /> SQvor�r Application and P�rmit <br /> N O. G�U Z 4 D AT E Deceaber�4, t a0�.s-- — <br /> Servi .e Address _ _ Utility Account No._. <br /> Billing Address Fn� av� �� xti� 5:.:g— �� Permit Fee �p �� <br /> City, State, 2ip fvn �t, wa aa�na Connection Chargels) ,an n <br /> Qwner (Mc�rtgagor)_�anauL^ � t� Total Fee .�p �^ <br /> Utility Development Fee Ord. 1171-85 <br /> Billing Nam�� G xY avater 224.00 i <br /> sewer 589.00 <br /> Connection By Sa� 813.00 . <br /> ;��' . , .�c1`�-�_ � <br /> Address c � Signed <br /> Cueiomer <br /> Phone <br /> DESCRIPTION: Sewer District <br /> Lot 18 Block Monthly Sewer Service'����u'' '°���`M 04t1NiTO'"�=�=: <br /> Plat rmrt� r ui�g <br /> � <br /> Unplatted Description_ — Monthly Sewer ConstAbJ027(i22 <br /> 5E��ff2 �'A.DO <br /> _ — Trunk��t� z'�n �m <br /> Type Permit: i�ew po¢�n@ction li'ii-`i i&1=.l�l <br /> Lateral �H �5�ttni�;E <br /> E.41Tf�' 450.Ut1 <br /> Remarks: _ Abutting Lot Line ����'1?49 <br /> N, S, E, W �±���fi S7tL.`,:d) ft. <br /> — t'I.IXi 465.�i1 <br /> rA.CN S�ii'.iNl <br /> ('L41 �II e�;.Fi; <br /> H SBCII ,.`.,ti <br /> Approved By xL�iti R•�7k�11t <br /> gineer ;'��J,Lk) <br /> I.f�('_��i ii�>t-�iJ <br /> Ih4PORTANT! Issued By susy Nauqan <br /> CALL 1-fl00-024-5555 48-HOURS <br /> PRIOR TO DIGGING � <br /> CALL 259�9811 �Ofl INSPECTION / r <br /> l <br /> Inspection B � <br /> Datelnspected ���� — <br /> II SEE SKETCH ATTACHED NO. L�O�L <br /> ir��s;�cc�ior! <br />