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everett <br />City of Everett <br />'1 <br />Sewer Application �g Pernit .�. tii - . <br />S iti i <br />NO. 27271 DATE '$ A aS 4 198 <br />Service Address_;I�lr p, <br />Billing Address 3314 1:5111bBe. SW <br />City, State, Zip <br />Owner (Mortgagor) <br />Billing Name <br />Connection By - <br />DESCRIPTION: <br />Plat <br />Unplatted <br />Type Permit: <br />Remarks: <br />IMPORTANTI <br />CALL 1800424-5555 48-HOUFIS <br />PRIOR TO DIGGING <br />CALL 2598811 FOR INSPECTION <br />SEE SKETCH ATTACHED <br />Utility Account <br />Permit Fee_ <br />CHART <br />TO POSTING-?-Z cl <br />Connection Charge(s) 330.00 <br />Total Fee 30.00 <br />Utility DewlopeoC yN Ord. 1171-85 <br />rater 179.C4 <br />se r 471.00 <br />Signed <br />Customer <br />Sewer District Aond III <br />Monthly Sewer <br />Monthly Sewer Constr. <br />Trunk 330.00 <br />Abutting Lot Line <br />N, S, E, W <br />Approved By �QQD Q. YQBAL <br />Cuv Engineer <br />Issued By ELev M—s- <br />Inspection B er <br />Date Inspected <br />ND. 27271 <br />INSPECTION <br />