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evereri <br />e. <br />City of Everett <br />Sewer �►pplicotion and Permit <br />,' N0. ZF)97T DATE l l- �� • �;�.-� <br />Service Address �� � LIL.�l7 m� i C. �'1 ) V C7. <br />Billi�fg Address <br />City, State, <br />Owner (Mortgagor) -"� _ <br />_ ` <br />Biiling Name <br />Connection By C� C': � r V C'- Y� t� <br />�IOfIB <br />DES ,IPTION: <br />Lot <br />Plat - y,s,t <br />Unpletteb Descriptio <br />Ty'pa-Permit: j� � <br />Remarfcs: � �, ( � <br />Block <br />rv,.�„� , � - <br />� A.s �cnnr.. �1,2 � ( ` <br />e �c���r_ w. �-/, ` „ � <br />'� 7�` .� � <br />f��li./:.r� �. <br />IMPORTANTI <br />CALL 1-800-124-5555 46•HOURS <br />PRIOR TO DIGGING <br />CALL 2�9�8611 FOR INSPECTION <br />/ SEE SKETCH ATTACHED <br />Utility Account No. <br />Permit Fe <br />CQ�n harge(s) <br />/P- <br />Total _ <br />Signed <br />cucromer <br />Sewer District ' <br />Momhly Sewer <br />Monthly Sewer Constr. <br />Lateral <br />Abutting Lot Line <br />N, S, E, W. <br />Approved By <br />City Enpinen <br />iss�edsy i1c>N M i 1(c � <br />/ <br />/� <br />Inspection B � <br />Date Inspected ��- �� <br />Na. 26977 <br />U � ILITY C!LLIi�G <br />