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evereri <br />e <br />City of Everett <br />CHART N <br />S6n17 To C�q,er�.��� <br />$ewer Application and Permit <br />No. 26133 DATE , <br />Service Addreu <br />Utility Account <br />Billing Address <br />City, State, Zip - <br />pwner (Mortgagor) <br />Billing Name <br />Connection By <br />14dfife55 <br />Phone <br />DESCRIPTION: <br />Lot�— Block_.�-- <br />■i7f M� l <br />Permit Fee <br />Connection Chargels) <br />Total Fee <br />i�elal IItilitr tN osd. 1171-65 <br />Mt�r 1lSS.00 <br />�= S1S1.00 <br />7106.00 . <br />Signed ; . `• ; _ <br />cu:tomer <br />Sewer District <br />Monthly Sewer Service <br />P18t w <br />Unplatted Description Monthly Sewer Constr. <br />Permit: <br />Remarks: <br />IMPORTANTI <br />CALL 1�800�424-555548•HOURS <br />PRIOR TO DIGGING <br />CALL 259�8811 FOR INSPECTION <br />SEE SKETCH ATTACHED <br />Lateral �4��=�`F:7 11L3�11M UOL1R1147i� ��� <br />/ <br />13ib1�789551 <br />Abutting Lot Line�,T.`U i1e32.94 n, <br />N,S,E,W . <br />pA.GG fiti�^9.50 <br />u s�u+ 41.SU <br />Eq� �S�FpC�_H� #SQ.O� <br />Approved BY ����9� <br />d72�1.D1'l <br />��,��� <br />Issued By �,a„ t <br />WR11F. 81�.(!0 <br />(�{ECK �119"�I.S4 <br />Inspection By <br />Datelnspected ���� ���- <br />1(�:SPf_C'1�ION <br />No. 26133 <br />