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everett <br />e <br />City of Everett <br />Sewer Applicction and Permit <br />No. 26408 DATE l��'t� -g8 <br />67� 3' � � <br />Service Address <br />Billing Address <br />City, State, Zip <br />Owner (Mortgagor) <br />Billing Name <br />Connection By ��+�� n' -(K' ti` F',fi'� <br />DESCRIPTION: <br />Lot Block <br />Plat <br />Unplatted Description <br />Type Permit: RehR! � � <br />Remarks: ��j}�,z. c� e , <br />_� <br />Y'Vv4 � �] � �� <br />�l� ��'� <br />S��—"� �� 7' � <br />�3''� ol /Y� N � <br />IMPORTANT! <br />CHART N0. ` � ' - � <br />; 1,7:,�r1�— M� ���� <br />/� ; � � Ir� :'vM <br />Utility Account No.�[,�7 � — � �� <br />Permit Fee <br />Connection Chargels) <br />Total Fee <br />Signed <br />Customer <br />$@W@f <br />Sewer Service <br />� Mo�thly Sewer Constr. <br />�, � \ Trunk <br />i � <br />Qg Y�� Lateral <br />Abutting Lot Line <br />, N, S, E, W ft. <br />, <br />> <br />/ 7�a <br />Approved By <br />Gry Engmeer <br />CALL 1A00-024�555548•HOURS <br />PRIOR TO DIGGING <br />CALL 259-8811 FOR INSPECTION <br />SEE SKETCH C,TTACHED <br />�SSU2(� BY „C� IV /Yl i���' V <br />Inspection By <br />Date Inspected_/Q_� � ' g � <br />C_i;:`t��.:'r,li_f�r,0! � <br />No. � 640�5 <br />