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evereft <br />e <br />City of Everett <br />Sewer Application and Permit <br />NO. ����� DATE �ly �e� iaaa <br />Service Address 909 81a� st. <br />Billing Address 5037 33rd 1►w. r. <br />City, State, Zip_ I'wr�tt. Ip1 98203 <br />Owner (Mortgagor) sill O'sri� <br />Billing Name � <br />Connection By �+ <br />Address_ s�.. <br />Phone 3s�-a2s� <br />DESCRIPTION: <br />Lot �'8 Block 1� <br />CHART N0. <br />��5� '�a Rx'il �1K'. <br />B.Zs.�7 <br />Utility Account No. <br />Permit Fee 3n_ee <br />Connection Chargels) �+. <br />Total Fee— ae_ee <br />Otility ! D�w2op�sat <br />wtar 152.00 <br />�s �wx <br />552 00 <br />Signed <br />Customer <br />!w Oed. 1171-eS <br />400,00 <br />� .ssi�ew.:::iu.�:: .�. .aa <br />Plat s►�s'�et Di� T Monthly Sewer Sen�l �176 <br />(X'T.�'i 04262.OD <br />Unplatted Description Monthly Sewer Con�pp�95,5 <br />Uf�TEIt 460.OD <br />Typa Permit: Trunk�p�y�>676� <br />5t11F3: f30.I10 <br />Lateral ti71-S =�Fn_m <br />Remarks: ��� <br />Abutting Lot Line� fl'�'.1X1 <br />N, $, E, yyL' Sdti;rl �3. i0 ft. <br />OR'1NV f�"O.UO <br />I10001Ri?`,rt <br />Gr1TEk f60.00 <br />ip700�67G8 <br />Approved By ■ � �.W- <br />, ��.i . <br />IMPORTANT! ��`� '� <br />Issued B v. 7•� <br />CAL�U800-424-555548-HOURS Y �; n�;,SO <br />PRIOR TO DIGGING p�,tr�,� q�,pp <br />(,'H[Cf: lSYl0.t7f) <br />CALL 269�8811 FOR INSPECTION l � <br />�y <br />Inspection By -�K/��'`� <br />SEE SKETCH ATTACHED <br />Date Inspected f--��'fj <br />Ii�SPcCTIGN <br />N0. 267v8 <br />