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everett <br />e <br />Gty of Ewron <br />�7 ee Uf�' /,' ��. s�e � <br />oN /�L�/� �'1' �5�i�n F� <br />Sewer Application and Permit <br />CHART <br />c�,, � � Cl, w.�`.,.��, `��3�88 <br />No. 26585 onTE �e io, i�es �_ <br />S�►vice Address_ ���tC �s Utility Account No. <br />Billinq Add►ess f1++ �+-�� �1w Permit <br />City, Sute, Zip <br />Owner (Mortgegor) �-- �+--� <br />8illinq Name <br />Cwmectio� By <br />�10�IQ Hi�si20 <br />DESCRIPTION: <br />Lot 1 Block 6S� <br />Plat s..�...�i�. ����.,� <br />Unplatted Description <br />Type Permit: � <br />Remarlcs: <br />IMPORTANT! <br />CALL 1�800d24-5555 48-HOURS <br />PRIOR TO DIGGING <br />CALL 2595811 FOR INSPECTION <br />SEE SKETCH ATTACHED <br />�0.00 <br />Connection Chargels) �t <br />Total <br />ordinana 1171-8Sa <br />Mr�r 100.20 <br />wt�s 151.80 <br />552.00 <br />Signed <br />cus�omer <br />�0.00 <br />Sewer District �d � <br />Monthly Sewer <br />Monthly Sewer Constr. <br />Laterel <br />U3/21/rJi: y:DoFai fNHY1M?E.�4 1 t tt <br />Abutting Lot Line .' <br />N, S, E, yyA0iA196U0 ft. <br />(�.1lCi a i��. � � <br />B �FGI I S; . `.:i) <br />f: �i'LH 'ti.�l) <br />ql'lkJ:'d:K°� <br />Approved BY �fl R•'�' <br />i ��vE1w��e4.3.�..in, <br />;l� 9 a; [.r� :7.i <br />Issued By �+ y'i� w i���� •d <br />-��'9 �k.,"tli <br />Inspection By �' <br />Date Inspected ����� <br />No. 26585 <br />�ftCPr�.l�r;,; <br />