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everen <br />� <br />City of Everett <br />Sewer Application and Permit <br />NO• 25Q11, DATE �t �24/85 <br />6719 8iyhlaed Drlw <br />Service Address <br />1012 Pezk Drive <br />Billing Address_ <br />L•berett, Ha. 98Y03 <br />City, State, Zip <br />Owner (Mortgagor�hnr El�1uW�It Brandvold <br />Bilting Name Arth°r Hrandvold <br />Connection By_ <br />Phone 353••3952 <br />DESCRIPTION: <br />Lot 13 _ Block 3 <br />Plat pO� �`rerly Park <br />Unplatted Description <br />Type Permit: Gp-off <br />CHART <br />$�.dT f'.� C�,?f�,�r.�,c'c- i/�8F <br />Utility Account No._ <br />Permit Fee Z•50 <br />Connection Charge�s <br />Total Fee �•50 <br />Signed ' ( <br />�customer <br />SEE SKETCH ATTACHED <br />IN;PGCTION <br />Sewer District <br />Monthly Se��er Service <br />Monthly Sewer Constr. <br />Lateral <br />Abutting Lot �ine <br />N, S, E, W, <br />A. R. Theal <br />Approved [iy <br />City Engincer <br />i. BOfIC� <br />Issued Bv_ <br />Inspection B <br />Date I �;uect <br />Na� 25011 <br />