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everen <br />e <br />City of Evarett <br />S�wer Application and Permit <br />No. 27019 DATE n.o..n.= s9, ieea <br />Service Address i6i� t � <br />Billing Address �� �� <br />City, State, Zip A-��, �� 9tSZ01 <br />Owner (Mortgagor) r+ v��+s -..�- <br />Billing Name d-- <br />Connection By� �_-• <br />Address �.� <br />Phone i ��a af9Y --- <br />DESCRIPTION: <br />Lot 3 Block <br />Utility Account No. <br />Permit Fee � - <br />Connection Charge(s) �.. ..- <br />Total Fee <br />Utiiity Dtwlapw�at O!N Oed. 1171-� 85 <br />wat�s 17l.00 <br />NNz �7I.00 _ ' <br />650.00 <br />Signed _ <br />Sewer District�� <br />Monthly Sewer Service <br />Pfat tiuqa� � �+� n��t <br />Unplatted Description Monthly Sewer CoASd1S0/88 10�51RM OOONq3913 tCk'3 <br />/ <br />Permit: <br />Remarks: <br />IMPORTANT! <br />CALL 1-BOOd24-5555 48•HOURS <br />PRIOR TO DIGGING <br />CALL 259�8811 FOR INSPECTION <br />SEESKETCH ATTACHED <br />Trunk I1000270if1� <br />bE��IIER d .OD <br />Lateral E'�3 II '"70 W <br />iS71 `S �b5p.011 <br />Abutting Lot Line �+a�i1�� <br />N S E W 6JR1ER 3d�7.00 ft. <br />�3. �. <br />GtIiO 341k^..UO <br />f�1.Eii t45.G0 <br />1�1�1 :54.rx1 <br />Approved By �� �� 31 �.�_ <br />c+ <br />E S(a,'II 515.00 <br />!k?UN'J E�''O.OQ <br />Issued By <br />Inspection By��-�'� � <br />� <br />Date Inspected <br />Ifd�PECTION <br />No. 27019 <br />