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everett <br />ti <br />.,i�'`i� <br />.�� ��. <br />City.of Everett <br />Engineering & Community Services <br />��wv�c� A��6c���6��� a��d ����i� <br />NO. 27O5G DATE � ��7 <br />CHART NON �'�' "��- ✓� <br />;i: <br />r�.- ' <br />�_ .' - . . <br />� .i i�� <br />�' �. • <br />I '� <br />U' _.... <br />Service Address �^S�� �� ,'-!r .�->„ _/"� Utility Account No. '?` �� � , � � 4� <br />,: 3 �_ <br />Billing Address�� �� L�� `i i__��x= -�---� Permit Fee d <br />� �,. <br />City, State, Zip- �%+ •-- � �•-'� d' �- , �iPr'J � Connection Charge(s) <br />/ �1 `� <br />4 / <br />/ �, � <br />Owner (Mortgagorj��•�=-� ;�'=•y %. �'-��rl�r-•�f! •` Total Fee -j� <br />Billing Name --�=-��=�-`-"' <br />Con�ection By i"�� : . -�— <br />, • r , <br />Signed_ � % � <br />Customcr <br />Phonc_ 3 J�3 � J��S � <br />DESCRIPTION: ' Sewer District <br />Lot �'�� , Block Sk� �. j o <br />P��f �, Z-;_��� � Monthly Sewer Service <br />Unplatted Description MonthlySewer Constr. , <br />SEE'SKETCFI ATTACHED <br />Lateral <br />Abutting Lot Line <br />N, S, E, W <br />APProved B�� ��": ,r,, � _` _. <br />Ciry EnO��cer /�' � <br />� � 6 <br />�� � <br />/ �,� ; <br />Issued,f3y�!/�—rL�—_r� <� <br />Inspection <br />Oate I <br />NO. �2QJG <br />-- -----•-� INSPECTION --•-.--•--. -----_-� <br />� r . � <br />..�...._.-._._......_.....�_ W.___ __.�� f...Y�...�-----_...__._ _,�.._.�.__ ___...� _. <br />� <br />