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everen <br />e <br />City of Everett <br />`W' <br />� <br />� <br />� <br />O <br />� L� <br />1 CJ <br />Sewer Application and Permit � , � � <br />n _ u <br />27176 � �� '� <br />N0. DATE M ►�Y �. 19E9� � <br />Service Address 1628 Pugot Dz. <br />Billing Addres <br />City, State, Zi <br />Owner (Mortc <br />1901 W. Llncoln l�n. <br />Yakiaa. N]► Q 98902 <br />Gr�! Innstm�nLs <br />Billing Name S� <br />Connection Bv �° <br />Address s�° <br />Phone_ <br />DESCRIPTION: <br />Lot <br />Plat <br />Unplatted Descr <br />Type Permit: <br />Remarks: <br />(509) 575-7950 <br />Block <br />Nav Cona�ction <br />IMPORTANT! <br />CALL 7$00-024•5555 48-HOURS <br />PRIOR TO DIGG�NG <br />CALL 259-8811 FOR INSPECTION <br />SEE SKETCH A"fTACHED <br />CHART <br />Sc,�f ia �,�os� .�y s' 7 -�t� <br />�JJ'JJ � � i�l � L� <br />7! 1'� {A O Y p p 'i <br />L'J w .-� C��l � L"l `�l <br />M M M .a� C\I Y1 tM <br />w� � <br />._ � � <br />=������'�W� <br />r. : � <br />r_t^��'� <br />��.�� _�;�, �:, <br />Utility Account No. <br />Permit Fee �-0� <br />Connection Charge(s) 270.00 <br />Total Fee 30.00 <br />Otility Dewlopa�at !ee Ord. 1171-85 <br />�v�at�r 17�:p0 <br />� .00 � <br />0.00 <br />� ,. , <br />Si ned % - �/�'�+�6'i. � f.. �. <br />9 ' . ''�. mtomer <br />Sewer District B�a II <br />Monthly Sewer <br />Monthly Sewer Constr. <br />Trunk 270.00 <br />Lateral <br />Abutting Lot Line <br />N, S, E, W ft. <br />Approved By ��n R. TAEA�. <br />City Engineer <br />Susy tiaugan <br />Issued Bv <br />!/ / <br />Inspection B� <br />Datelnspected �- <br />No. 27176 <br />INSPCCTION <br />