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everett <br />e <br />City of Everett <br />����o�� ,� <br />DEC 07 1983 <br />CITY OF EVERETT <br />pi:t::c \4���ks Deot. <br />Sewer Application and Permit <br />���zgiO3 <br />NO. 246%7 DATE <br />f3103 Hm�let Lsttn <br />Service Address <br />270� 128th ltrest S.N. <br />Billing Address <br />firer�tt, Ma. 9D104 <br />City, State, Zip <br />Duane Berq <br />Owner (Mortgagor) <br />Billing Name — <br />Cunnection By <br />Phone ;5�-G229 <br />DESCRIPTI ON: <br />Lot � � Blocl< <br />Plat _Vall�y Viw f1I <br />Unplatted Description <br />�TVnP Parmit• NW COIIi1CCt�0II <br />76298-9 <br />Utility Account No. <br />�0.00 <br />Permit Fee <br />270.00 <br />Connection Charge(s) <br />30.00 <br />Total Fee <br />prA;n�nd �722-80 <br />11�.�ea II 27�D0 — <br />Signed <br />Cusromer , <br />Hond iI <br />Sewer District -- <br />6.50 <br />Monthly Sewer Service <br />Monthly Sewer Constr. <br />SEE SKETCH ATTACHED <br />INSPECTION <br />Abutting Lot Line <br />N, S, c W <br />Approved By_�� A' �eal <br />City Engineer <br />E. Hond <br />Issued BY <br />InspectionBy�� *6e%""^ <br />Date lnspected /- 3o ty <br />No. 24677 <br />