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eve�en <br />e <br />City of Everett <br />Sewer Application <br />NO. 27221 DATE <br />Service Address <br />Billi�y Address <br />City, State, Zip • <br />OwnK (Mortgagor) • <br />Billinp Name <br />Connection By <br />Addreu <br />Phone <br />DESCRIPTION: <br />CHART <br />SENT "in c.t�►e'RWfo <br />3,2,� <br />S O O � <br />a: �.; <br />r��.:: <br />~w rPi � <br />� <br />.. <br />�� <br />���� <br />Utility Account No. <br />Permit Fee <br />Cor„�ection Chargels) � <br />Total Fee _ <br />nctucr n.wiop...e r.. ora, iui-�s <br />wt�r 261.00 <br />� �wwz 6Ye;.00 <br />�! <br />Signed � : � �.. � ,! G��� <br />� �.mtomer <br />Sewer District <br />Lot B��k Monthly Sewer Service — <br />Pl�t <br />Unpletted Description Monthly Sewer Constr. <br />Typs Permit: <br />Remarks: <br />IMPORTANTI <br />CALL 1-800d24-5555 48•HOURS <br />PRIOR TO DIGGING <br />CALL 259�8811 FOR INSPECTION <br />SEE SKETCH ATTACHED <br />Trunk <br />Lateral <br />Abutting Lot Line <br />N, g, E, yy �p h. <br />Approved By _ <br />� <br />Issued By <br />Inspection By �"'� �— <br />Date Inspected Z ' � �'" SO <br />INSPECTION <br />No. 27221 <br />