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CHART NO. <br /> everett <br /> � w s�'� To C�i�'�^r.ti�c– /Z�3f67 <br /> Y�� <br /> R <br /> � <br /> City af Everett � � � � 8 $ �,' =. :� ,:; <br /> �1 Cr _� <br /> ��e- i t�l �O n ��1 �G' iJ c= �-� :J <br /> ;Y: ... :h .» .? et :�] � n1 <br /> sY tl ;J <br /> Sewer Application and �rmi� T � � <br /> ::; . .. �. <br /> r� � N <br /> _ � � � 'F � � � � '�1 ~ � � � (� � <br /> +�..J� T y/ <br /> / �.'L � tL � :�1 :Jl 0 :5 �' '"' :(1 4��' •-� J <br /> No. �?6018 DATE �gg� <br /> Service Address�pK. �–, Utility Account No. <br /> 8illing Nddress � Permit Fee 3p,p: <br /> City, State, Zip�����--R,���gg Connection Charge(s���_ <br /> Owner (Mortgagor) n u.{� n..,,ra _ Total Fee__�,gp <br /> Billing Name *+s��ra Cnstcra+ fiosros, Ino Special Utility Fee, Ozd. 1171-85: <br /> aater $224.00 <br /> Connection By SAcr __ eorer 589.00 <br /> f313.J0 ,. �• <br /> Address Signed �– — <br /> Customer <br /> Phone � ����, <br /> DESCRIPTION: Sewer District <br /> Lot�� Block <br /> Monthly Sewer Service <br /> Plat yerfaier pLd.ye <br /> Unpl�.�d Description Monthly Sewer Constr. <br /> ---- --- Trunk _ <br /> Type Permit: N�� r�n..,.,,t;� _ <br /> Lateral <br /> Remarks: <br /> Abutting Lot Line <br /> N, S, E, W ft. <br /> — Approved By <br /> i n <br /> IMPORTANT! <br /> I�sued By <br /> CALL 1-800-024-5555 a8-HOURS ' ' <br /> PRIOR TO DIGGING <br /> CALL 259-8811 FOR INSPECTION ti <br /> Inspection By <br /> Datelnspected � <br /> S[f.: SKETCH ATTACHED �� �0.� 26010 <br /> I <br /> ir��:c��; c�ior! <br />