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CHART N0. <br />everelt <br />� <br />City of Everett <br />Sewer Application and Permit <br />NO. �5997 DATE �- S-CIO L. <br />ServieeAddress ��2Z- �t.�2 � �I}�_ Utility Account No. <br />Billing <br />Permit <br />City, State, Zip Connection Charge� <br />Owner (Mortgagor) <br />Biiling Name <br />Connection By �� f�l 0� �✓C�, r� ��' <br />Address <br />Phone <br />DESCRIPTION: <br />lot <br />Plat <br />Unplatted Descr <br />Type Permit: <br />Remarks: <br />, <br />Block <br />� 8 � _`JP.Q <br />1Q SO�� b O e.� iTh <br />��Q, o.i �ll/ [s <br />�,�L. 7•,(�. � <br />IMPORTANTI <br />CALL 1�ODd24-5555 •18•HOURS <br />PRIOR TO DIGGING <br />CALL 259�8811 FOR INSPECTION <br />SEE SKETCH ATTACHED <br />Total Fee <br />`'- <br />9� <br />, \ a,; f� �. I�� � <br />;; <br />; <br />Signed _ <br />cu:,omer <br />Sewer District <br />Monthly Sewer Service <br />Monthly Sewer Constr. <br />Trunk <br />Abutting Lot Line <br />N, S, E, W <br />Approved By <br />Ciry Enpinea <br />Issued By�! ri(�G%�' <br />Inspection By <br />Date Inspected 7- �o —�O <br />rvo. �699 � <br />CUSTOi�.�[f; CCf'1' <br />n. <br />