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CHART NO. — <br /> everett <br /> � S�Y.� � �O'sT�/1 I <br /> \ <br /> �:i�y ot Everett ����' 'S l <br /> �ewrer �pplication and Permit <br /> No. 26249 DATE ��q �. 1997 <br /> Service.Address 110 Y. Nc�ill �va Utility Account No. <br /> Di,^�E1FIi �-.=('if't1 qOt,lpHb337 Gt:'G <br /> Billing Address 191� x 34 n �n . io7 Permit Fee '+��-� <br /> tiOuL�l�:'b0 <br /> City,State, Zip �t�� �n► 9B1o3 Connection Charge(s) �ro:_�y�p,�y <br /> �-�30.00ShS.IXJ <br /> Owner (Mortgagor) c+�.�.roo v.� Total Fee �y� q,?d,r�} <br /> Billin Name sa�r �cial IItilitp Lha� �Al �`d�17].-85+ <br /> 9 vater 174.00 1= SI.tiH 9i5.00 <br /> eever �71.00 Dk.�1' G:�Q.i0 <br /> Connecti�n By �s \ 650.00 Nlkk11•i=�(1 �/j� <br /> j,...._...( ,{�I.fg!��-�i4�6!W <br /> Address Signed � , . <br /> a:� <br /> NF_I.N �^8.50 <br /> Phone L�-ga�a D `':;itCH :3.;,0 <br /> � <br /> DESCRIPTION: Sewer District_�P.�L�.y:� <br /> Lot � _ Block g i;1�iG349 <br /> Monthly Sewer Serv�c�P : <br /> Plat Iatasaih Di� I ¢1�-• <br /> Unplatted Description Monthly Sewer Cons1YE'r' `y5'� <br /> I',tj.7� �r:'�..� <br /> — Trunk �' ''�� a�"�� <br /> Type Permit: Hw Cmwetion ` � • <br /> Lateral���..�r'�w�f '�'� <br /> NlSn..:Q1 <br /> Remarks: ;CL�ft 4't0.[l0 . I <br /> Abutting Lot Line�;�iJt g�`�y.� <br /> N. S. E. W-l�;',��-1f�'u��b9 ft. <br /> ;ii u.;U`'S2h9 <br /> �F.1&R 4.U.OU <br /> LtID 1 I1 m725.pi) <br /> 117f:i ?G5U.00 <br /> Approved By G E s. R'�11L <br /> :-.Lt�.h.npineer 4,iV.[I� <br /> IMPORTANT! UYU)ll.i b7�5.(�7 <br /> Issued By� ����E• �� . <br /> cALL 1500-024•5555 48•HOURS !;(iDl�0��1i4 <br /> PRIOR TO DIGGING ���-� ,y�� �� <br /> CALL 259-8811 FOR INSPECTION �� Y6, <br /> dli d 1 1 � <br /> Inspection By — <br /> i� L iUQ.U! <br /> Date lnspected � o ? , <br /> SEE SKETCH ATTACHED Np, G6Z49 <br /> I;�:SF�CTION � <br />