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evereft <br />e <br />City of Everett <br />M <br />Sewer Application and P <br />25757 J.1yG,9er <br />NO. DATE <br />Service Address M1 soled age <br />Billing Address <br />2010 tln*ar <br />City, State, Zip xv rattr "W "201 <br />Owner (Mortgagor) QE4 110 rim <br />Billing <br />Connection By <br />Utility Acccunt No. <br />Permit Fee 2.50 <br />Connection Charge(s) _ <br />Total Fee 2.50 <br />Address Signed <br />/ Customer <br />Phone ! <br />DESCRIPTION: Sewer District <br />Lot 11 _ Block 720 _ <br />Plat of X"Wtte Div. E Monthly Sewer Service <br />Unplatted Description Monthly Sewer Constr. <br />Type Permit: <br />Remarks: <br />Tru <br />Lateral <br />Abutting Lot Line <br />o '5 71leo N, S, E, W. <br />Approved By ATJIM A. Tttt" <br />City Engineer <br />IMPORTANTI <br />Issued By �raar�t _. Ilst�od <br />CALL 14300-424-5555 48•HOURS <br />PRIOR TO DIGGING <br />CALL 259.8811 FOR INSPECTION <br />Inspection By — <br />Date Date I nspected 3 O — o <br />SEE SKETCH ATTACHED NO. 25157 <br />INSPECTION <br />