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everen <br />e <br />City of Everett <br />Sewer Applicatior� and Permit <br />No. 25170 <br />DATE �lY �. 14H5 <br />Service Address 4906 Oe��n At�nw <br />gilling Address � <br />City, State, Zip �zP�iil�, Na. 98270 <br />Owner (Mortgagor) ��d p�O� <br />Billing Name <br />Connection By <br />CHART <br />���.�� S�.�T �,� <br />G //.9/_�ri.c/G Z - i <br />Utility Account No. <br />Permit Fee 30.00 <br />Connection Charge(s)720'� <br />Total Fee 30'� <br />Ordinance 981-83 <br />800.00 <br />j <br />Signed � � - ��. <br />Cusromer <br />Phone 653-IY�4 _ <br />DESCRIPTION: Sewer District <br />Lot 2 Block <br />Plat �i� �ed�iar lracts Monthly Sewer Service. <br />Unplatted Description Monthly Sewer Constr. <br />SEE SKETCH ATTACHED <br />INSPECTION <br />Abutting Lot Line <br />N,S,E,VV <br />Dond II <br />6.50 <br />270.00 <br />450.00 <br />Approved By �• R. Theal <br />City Engmeer <br />Issued By s. aond <br />Inspection.8y=� "' ��/��— <br />Date Inspected � — 3 -� <br />No. 25170 <br />