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everetl <br />e <br />City of Everett <br />CHART <br />c��1'� -ro FbS'Cl�, <br />g.z�.8, <br />Sewer Application and Perm�t <br />NO. 2676`� DATE .h,� �n, l0Y• <br />Service Address �� p� � <br />Billing Address �37 33rd 1►w. r. <br />City, State, Zip �'�tt lp1 9t20� <br />Owner (Mortgagor) �1 O'ari� <br />Billing Name � <br />Connection By � <br />Utility Account No._ <br />Permit Fee 30.00 <br />Connection Charge�s) N0O° <br />Total Fee 30.00 <br />tltilltp 1t D�rylopwnt <br />Mt�r 179.00 <br />�wr 471.00 <br />650.00 <br />l�e� Oed. 1171-aS <br />Address �53-�� Signed <br />us omer � <br />Phone ti00013� 76 <br />t�'T.2�C�! ^6:.'.�0� <br />DESCRIPTION: Sewer District_Npg�, - <br />Lot s�' Block �ii� �•ro <br />Plat ��tt Di� T Monthly Sewer Sen � <br />�.11�T 430.00 <br />Unplatted Description Monthly Sewer Confjc�l-5 4650.00 <br />Trunk ��`�`� <br />Typa Permit: " <br />B fiRLli 33.50 <br />Lateral .,..�_��8.� <br />Remarks: ��5� <br />Abutting Lot LineGqT� 460,00 <br />N, S, E, W1lfifmr.7t,A ft. <br />`.�l�R 9�.00 <br />llil-5 35S2.p0 <br />IMPORTANT! <br />CALL 1�00-024•5555 48•HOURS <br />PRIOR TO DIGGING <br />CALL 259�8811 FOR INSPECTION <br />SEE SKETCH ATTACHED <br />ti00ik^030U <br />E'LGIi �117.OG <br />Approved By � `����`���*- <br />�(inyinear4�11.OQ <br />l7£CI( 55970.U0 <br />Issued By s�+ � <br />�� <br />Inspection By <br />Date l nspected � 't � � �� <br />INSPECTION <br />No. 26769 <br />