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everett <br />e <br />City of Everett <br />d <br />Sewer Applica�ion and Permit <br />No. 2.6951 <br />DATE � ' �`"� � g� <br />Service Address � N� 5 �'✓R S S'9v S f <br />Billing <br />CHART N0. K ?0-29-5 <br />��8� Fo�iE'C; -r• i u r. � M 5 <br />Utility Account No. <br />Permit Fee <br />City, State, Zip Connection Chargel <br />Owner (Mortgagor) Total Fee <br />Billing <br />Connectio� <br />Address <br />DESCRIPTION: <br />Signed <br />cusromer <br />Sewer District <br />Lot Block <br />Plat Monthly Sewer Service <br />Unplatted Descript�on Monthly Sewer Constr. <br />Type Permit: R� �R � �.. <br />Remarks: , � � <br />%Yl�l / <br />6" C� <br />�� �l� �,e iG , <br />`� ' � I C e ��A I <br />IMPORTANT! <br />CALL 1$00�424-5555 48-HOURS <br />PRIOR TO DIGGING <br />CALL 259�8811 FOR INSPECTION <br />SEE SKETCH ATTACHED <br />Trunk_ _ <br />Lateral <br />Abutting Lot Line <br />N, S, E, W, <br />Approved By <br />C'ty Enpineer <br />�ssued ay_ fi,� n/ M � lle r <br />Inspection By <br />Date Inspect d /��� — b� I <br />No. 26951 <br />UTILi'i 1' L'ILLING <br />