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everett <br />� <br />x <br />� <br />City of Everett � � � � � <br />s � µ � � <br />o-• M <br />Sewer Application and Per�i �° � <br />o : ����;� <br />N0. ZVvy3 DATE ��t 22� 196� '' ""` <br />Service Address � �� ��• <br />Billing Address � <br />City, State, Zip ���'�tt, fP� 94203 <br />Owner (Mortgagor►_ � �� �11 <br />Billing Name � <br />Connection By � �ti• <br />Address 'u9 169tL 1i�. tta �o�L• <br />Phone 3'a-56{2 <br />CHART <br />Utility Account N <br />� �: ., �� �c• «2 .:t< � <br />�BS�s� ,�� <br />:;��;�� � � <br />.w H w J � � � <br />� <br />r�- `� � <br />�� ia� ��� <br />�����s�� <br />Permit Fee 30.00 <br />Connection Chargels) n�•� <br />.3-�s;�9 <br />�� <br />Total Fee 30.00 <br />Utili�y DeYclop�E !N Ocd. 1171—BS <br />�t�z 17l.00 <br />�ever 471.00 <br />650.0� � <br />Signed � � � � ' �/� � _ _ <br />Customer <br />DESCRIPTION: Sewer District saod =I <br />Lot 7 Block 1 Monthly Sewer Service <br />Plat =�� �n�� <br />Unplatted Description Monthly Sewer Constr. <br />Permit: <br />Remarks: <br />IMPORTANTI <br />CALL 1�800�424•5555 48•HOURS <br />PRIOR TO DIGGING <br />CALL 259�8811 FOR INSPECTION <br />SEE SKETCH ATTACHED <br />Trunk 270 00 <br />Laterril �SO 00 <br />Abutting Lot Line <br />N, S, E, W <br />Approved By � �� a� �� <br />cia enyineer <br />Issued By 8� a�� <br />Inspection By -�"` `""�i -- <br />Date I nspected 2� t�,� <br />INSPLC 110�J <br />No. 268i3 <br />