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evereri <br />� <br />City of Everett <br />.-, <br />fi <br />$ <br />� 8@ <br />� �5 <br />Sewer Application and Permit� `" � <br />c � � � � <br />NO. �v821 DATE � <br />Service Address �+�� �+� � li�i Utility Account <br />Billing Address_.g,:, �-3;_S <br />City, State, Zip ..���+� �� , ILl► YOS'7i <br />Owner (Mortgagor) <br />Billing Name �--- - -- <br />Connection By <br />Address <br />Phone <br />Permit Fee <br />CHART <br />1 �/�/ n <br />� '.3L-( �., l/iC� ��L.l l� �- <. � � 'I <br />�9�g8 88 8 Si� <br />r- r%• oi .n� r'� � o- <br />� .a .+ �i r : F� ., r. <br />M M M M[�. (y V; O <br />�r, .. ». rs <br />� a <br />����-+ N <br />1 ti <br />����� �� <br />Connection Charge�s) <br />Total Fee <br />Dlllitp D�rylopr�ett !'N Oe4. 1171-BS <br />Yit�' $2�.00 <br />sw�r 589.00 <br />81):00 / <br />' r � ' � <br />Sig�ed � , <br />cu:tomer <br />DESCRIPTION: Sewer District sond I= <br />Lot Block Monthly Sewer Service <br />Plat <br />Unplatted Description Monthly Sewer Constr. <br />Type Permit: <br />Remarks: <br />IMPORTANTI <br />CALL 1�Q0�424•5555 48-HOURS <br />PRIOR TO DIGGING <br />CALL 2595611 FOR INSPECTION <br />SEE SKETCF' ATTACHED <br />Trunk <br />Lateral <br />Abutting Lot Line <br />N,S,E,W <br />Approved By <br />� <br />ISSU2d BY <br />Inspection By `-/�' �P/'G1"— <br />Date I nspected S/�/�% <br />No. 26821 <br />Ii\.`� �i_:; I ICi`1 <br />