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everett <br />e <br />City of Everett <br />Sewer Application and Permit <br />NO. LJ��v DATE <br />, <br />Service Address sjpr,rrr�+�... s�..a <br />Billing Address j�q4��p{�T, �;g <br />City, State, Zip�g`� <br />Owner (Mortgagor) �.�•—•�„�ra• <br />Billing Name j�: <br />Connection By <br />Phone ��;+�• <br />CHART <br />T-34-29-4 <br />..JG`NT T.7 C'F'H(Ti//G �'L�9-S% <br />t#J/08if�b 1:1]PN OOOAq13b5 S'Ytt <br />/ <br />fA.Lt", 9P+39..`A <br />Utility Account No. F �a ��-� <br />ifECN l94.50 <br />Permit Fee ;o �'� �11%-ni <br />B SFCH 41.5t1 <br />Connection Charge(s) ����ts_rn <br />GRtNdY 32U.00 <br />Toeal Fee �C,���t <br />Spec1�1 Uti� F�e �=5.� <br />OM. 1171�5�t�r 224.00 <br />�r�rt se+�•u�9 00 <br />uc��'�ec �13;a3 <br />tiENEli i i74.i1(l <br />Signed E�D ti �7.i1 {X1 • <br />c°�ir�`-S 4813.00 <br />fJI�rL7; l,c+b0.50 <br />DESCRIPTION: Sewer District ��. <br />Lot�_ Btock�— Monthly Sewer Service <br />Plat <br />Unplatt escripUon � Monthly Sewer Constr. <br />Permit: <br />Remarks: <br />IMPORTANTI <br />CALL 1�800�24•5555 48•HOURS <br />PRIOR TO DIGG�P�G <br />CALL259S811 FOR INSPECTION <br />SEE SKETCH ATTACHED <br />Trunk ��.... <br />Lateral 459."" <br />Abutting Lot Line <br />N, S, E, W <br />Approved By E <br />Issued By <br />Inspection Bys�� <br />Date Inspected � �y—% 7 <br />INSPECTION <br />No. 25788 <br />