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everett <br />e <br />City of Everett <br />Sewer Application and Permit <br />CHART N0._ <br />�,,.'� r� C'/u��°.. �. S' -/� -SB <br />No. 2f 5a3 DATE aanu.:v ls. 19e6 _� <br />Service Address Sl� �'�1� Utility Account No. <br />Billing Address $� <br />City, SWte, �ip Eni�tL, tf� 9b20� <br />Owner (Mortgagor) Mc. D. IOu� <br />Billing Name � <br />Connection By_ __L�a�os <br />Address p.o. tmc 11Y8 ttukllt�o 982T5 <br />Phone- us-�s� <br />DESCRIPTION: <br />Lot � Block <br />Plat 1�b�ck tark <br />Permit Fee �0.00 <br />Connection Charge�s►_� <br />Total Fee ]Or00 <br />Sp�a1a1 Dtllity 1tia Ocd. 1171-dS <br />wter 22�.00 <br />- -.. � <br />Signed <br />cu:romer <br />Sewer District teed zi <br />Monthly Sewer Service _ <br />Unpiatted Description Monthly Sewer Constr. <br />Typa Permit: <br />Remarks: <br />IfvIPORTANT! <br />CALL 1SOOd24-5555 48•HOURS <br />PRIOR 70 DIGGING <br />CALL 259�8811 FOR INSPECTION <br />SEE SKETCH ATTACHED <br />Laterel <br />Abutting Lot Line <br />N� S' E' ' #.t <br />. . � <br />/ <br />Nli�llk��''J;. <br />SF�Ef? 330.D0' <br />Ii71-5 3�24.OU <br />I Approved By�� • � <br />f .f.�i �9��`i7r'.t7Q <br />f'Lk�t d�iS.00 <br />IssuedBy �x.y9��� <br />E SRCIi ;3.50 <br />L SRLH #15.()0 <br />IN2VW" 2� � OLt <br />Inspection By �+ { 'Y <br />. R-- <br />Date Inspected W���� <br />I �!SPECI'I ON <br />No. 265�J3 <br />