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CHART NO. <br /> everett <br /> e <br /> City of Evetett <br /> Sewer Application and Permit <br /> N0. 25135 DATE 6/6/85 <br /> 1f2S atar�i �� <br /> 5ervice Add�ess Utility Account No. <br /> Billing Address p'�' � 9� Permit Fee Z'� _ <br /> C�ty, State, Zip ��t� �4tO° Connection Charge�s) <br /> 1Nvlaad Oo��tivaticn Co. Inc. 2.50 <br /> Owner (Mortgagor) Total Fee <br /> Billing Name 6�° <br /> Connection By <br /> Address Signed �� <br /> cu:tmner ` <br /> 259-9191 <br /> Phone <br /> DcSCRIPTION: Sewer District <br /> Lot 1�'1� Block 76 Monthly Sewer Service <br /> Plat �+�tt <br /> Unplatted Oescription Monthly Sewer Constr. <br /> Type Permit: Gp-o!f Trunk__ <br /> Lateral <br /> Remarks: <br /> Abutting Lot Line <br /> N, S, E, W ft. <br /> A. Il. S�M�1 <br /> Approved By <br /> Cily Enpineer <br /> Issued By E. �ewa <br /> Inspectio / �N�d'— <br /> Date Inspected � � 3'�� <br /> SEE SKETCH ATTACHED N�• �S13S <br /> INSPECTION <br />