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everen <br />e <br />City of Everett <br />Sewer Application and Permit <br />CHART <br />ro CH,s+��r..u�� 7-z9-97 <br />N o. 2 60 1 9 DATE T�anarY 13, i9e� � <br />Service Address 5106 tv�,�nk s�r Utility Account No. <br />�895 76th 3t. S.N. 30.00 <br />Billing Address Permit Fee <br />City, State, Zip ��• ""�i��. � 9e275 <br />Owner (Mortgagor) e "��� �� M' <br />BillingName * ri .�� a��... <br />Connection By �.1t xs� <br />Phone u��IS <br />DESCRI?TION: <br />Lot 3 Block <br />Connection Chargels) � <br />Total <br />E�I���i�] <br />Sp�eid Utility te� osdlmaw R1171-OS <br />Nal�r �22�.00 <br />_�� <br />/ i _. <br />/ <br />Signed ��- r������ t�� �,— _ti i �. <br />Cusromer <br />Sewer District �d Ii <br />Monthly Sewer Service <br />Plet � �� �s <br />Unplattecl Description Monthly Sewer Constr. <br />Typa Permit: <br />Remarks: <br />IMPORTANT! <br />CALL 1500�424•5555 48•HOURS <br />PRIOR TO DIGGING <br />CALL259S811FORINSPECTION <br />SEE SKETCH ATTACHED <br />Trunk <br />Laterel <br />.. , � <br />1 <br />Abutting Lot Line��..91 <br />N S, E, W , ft. <br />i�2bU1R <br />�I�P. 430.00 <br />!I(X7U2i,019 <br />IliS-5 Y�`.4.OD <br />Approved By� <br />t .1 ' � �585.50 <br />I'L t']5.00 <br />Issued By g���� <br />e s�r:i+ sx.� <br />�: `;kL'H 915.00 <br />i��/�0.00— <br />s <br />Inspection By� <br />Date Inspected_ �- �-�7 <br />INSPECTION <br />No. 2601�! <br />