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!Y!I!n r <br />� <br />Gbi of Everett <br />� <br />�� <br />s <br />� <br />� <br />$ � <br />0 <br />.�e .. <br />N <br />�ewer Application and Permit �, � <br />c � <br />NO. �v857 DATE O�t�6�r 15. 19� �� <br />$avice Address ��y► ��eAla�d._is Utility Account <br />Billing Address <br />� <br />City, State, 2ip . <br />Ow�er (Mortgagor) e�... e..+�� <br />Billing Name <br />Connection BY—� � Ilitiel�lag <br />Address <br />Phone � ���� <br />CHART <br />,,j2•;,1� �.� C�1c.r.Lt�./ lD/S/88 <br />Permit Fee_ lp p� <br />Connection Charge�s) <br />Total Fee_ w.r yp pp <br />r �; �. <br />Signed— <br />icu:tomer <br />DESCRIPTION: Sewer District_ <br />Lot Block <br />Plat Monthly Sewer Service <br />Unplatted Description Monthly Sewer Constr. <br />Typa Permit: Il�pair <br />Remarks: <br />IMPORTANTI <br />CALL 7�800�24-5555 48•HOURS <br />PRIOR TO DIGGING <br />CALL 259$811 FOR INSPECTION <br />SEE SKETCH ATTACHED <br />Abutting Lot Line <br />N, S, E, W ft. <br />Approved By <br />City npiaeer <br />Issued By_ w=y�t t IIOL�oO <br />Inspection By ���'/�"'^"�'" <br />Date Inspected �'�6 - �� <br />No. 26857 <br />If:<'PGC'iIQ;J <br />