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evereh <br />e <br />City of Everett <br />Sewer Application and <br />N�• ���1� DATE <br />Service Address <br />8illing Address �om aw• �� <br />twr�t�, 1/A l�Ol <br />City, State, Zip �r.�..• .■ .. <br />Owner (Mortgagor) i►+.i s r1.e. r.....w.= <br />Billing Name_ �� <br />Connection By � n ,..w.�..., r,,,�.t���� _ <br />Address Re» w.�. n. �a�`y� _9822� <br />Phone_ ��S-i��0 <br />e- s <br />�+ v <br />����� <br />CHART <br />, <br />�... l�o c,4��.-�. ,-��_s9 <br />��gQu �i8 u`�y, <br />N � � O � (�� N � <br />C: F. <br />cv " : <br />� � <br />N <br />���������� <br />Utility Account No. <br />Permit Fee_ ao on <br />Connection Charge(s)_ .:....► <br />Total Fee p pp <br />Ordlc.+ntv 1171-P5: <br />�nt�r only 224.00 <br />Signed <br />Customer <br />DESCRIPTION: Sewer District_ a+..� tr <br />Lot }� Block_ <br />Plat �+..+. �.r....�. Monthly Sewer Service <br />Unplatted Description Monthly Sewer Constr. <br />Type Permit: ,�__ _______.__ Trunk <br />Remarks: <br />IMPORTANT! <br />CALL 1�600-024•5555 48•HOURS <br />PRIOR TO DIGGING <br />CALL 259�8811 FOR INSPECTION <br />SEESKETCH ATTACHED <br />Lateral <br />Abutting Lot Line <br />N, S, E, W <br />Approved By_ zr.esn * ��*. <br />Ciry Enpinex — <br />Issued By_-_ w.e..�.� g r„r�..w <br />Inspection By�`^''� <br />Date Inspected /-�-/ dF <br />N0. 26612 <br />INSPECTION <br />