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x�� <br />p7 pa7 y <br />�O'.d'.Z <br />9 H fn <br />K�n <br />H� <br />� y� <br />� �� <br />ON <br />��g <br />�I% Y (] <br />�H� <br />gy� <br />nC� <br />��� <br />HOy <br />everetl <br />� <br />City of Everett <br />Sewer <br />,_, <br />�_; <br />� <br />'� �����4�� � <br />` L'iN�A. � .,-� p <br />: i :J [� C� a. C 1 �« <br />1!'1 �A Y� .A «. — <br />Applicntion cira,c��Permit� � � � <br />� a�4z������� <br />27299 r =xa�����4: ���- <br />N0. DATE nrq■� nuyusc 3i i9e� <br />Service Address 931 Meplc St. <br />Billing Address 212e Rainicr nvc. <br />City, State, ZiP LYer�tt, wA 982U1 <br />Owner (Mortgagor) �t�Y ��Os�a <br />Billing Name_ S°a° <br />Connection By Tr�Bt Conetruction <br />Address 16001 Market St. �noho$inh 9[i290 <br />Phone �x ���-9G66 <br />DESCRIPTION: <br />Lot 16-v Block �RQ <br />Plat �'eretc Div T _ <br />Unplatted Descr <br />Type Permi:: <br />Remarks: <br />IMPORTANT! <br />CALL 1�800-024�5555 46�HOURS <br />PRIOR TO DIGGING <br />CALL 259�II811 FJR IM1SPECTION <br />SEE SKETCH ATTACHED <br />CHART <br />TO �'OSTING _�-t5'q3 <br />Utility Account Na <br />Permit <br />Connection Chargels) e:ene <br />Total Fee 30.00 <br />L'tility Dovelopwent Fee Ozd. 1171-85 <br />xatet 26.95 <br />cewnr 71.05 '. <br />98.00 _ <br />- _' -�._� \ .�-; <br />Siyned_ ___-_ - ' .� <br />cu:�omer <br />Sewcr District �++r+�rz e...rr,b �g <br />Monthly Sewer <br />Monthly Sewer Constr. <br />Trunk <br />Lateral <br />Abutting Lot Line <br />N, S. E, W <br />Approved By ar.vvwn A, �nrrnr <br />Ciry Enginner <br />Issued By S�ucy_�g� y�y�� <br />Inspection By v�"� �"�c� <br />Date Inspected '� �� <br />N0. 27299 <br />I i�J;'Pi=CTIOf� <br />� <br />