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everett �� <br />� <br />City of Everett <br />S�wer Application <br />No. 27193 DATE <br />�� <br />-s <br />� <br />� <br />���� <br />rv�:� <br />r <br />(� T P <br />M <br />and Pern�i�� <br />� <br />x.y se, �s9� � � � <br />Service Address 5003 Ilidiols Pl. <br />Billing Address 10325 1tt D��i�s 6d. <br />City, SWie, Zip i+� $w��. �► !t� 90258 _ <br />Owner (Mortgagor) P��i!!e xarboz oonst. <br />Billing Name � <br />Connection By � <br />Su� <br />Phone �3{-63]5 <br />CHART NQ. <br />_� TD C N��.Ub <br />�2 - L � -��( <br />Utility Account No. <br />Permit Fee �0_00 <br />Con�ection Charge(s) vnn. <br />Total Fee ]o_oo <br />Utilitp DawlopNnt /N Ord, 11T1—BS <br />vatar 221.00 <br />` i <br />Sig�ed � \ ''i "— <br />Customer <br />DESCRIPTION: Sewer Distric•�: <br />Lot 3• Block Monthl�/ Sewer Service, <br />Plat �'�+�+ �+��+ <br />Unplatted Description Monthly Sewer Constr. <br />Type Permit: <br />Rumarks: <br />IMPORTANi'! <br />CALL 1E00�424-5555 48-HOURS <br />PRIOR TO DIGGING <br />CALL259-8811 FOR INSPECTION <br />SEE SKETCH ATTACHED <br />Lateral <br />Abutting Lot Line <br />N, S, E, W ft. <br />Approved By �� R' T�' <br />City Engineer <br />Issued By �Y ��� <br />_/y /� <br />Inspection By�L <br />Date Inspected /�— z - �� � <br />No. 27193 <br />I\SPE�CTION <br />