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L <br />�r� <br />Ch y <br />9�fn <br />� <br />� H� <br />'�tl y'�Md <br />� <br />O�� <br />��8 <br />G] Y (7 <br />zH�yH <br />rHH <br />g �' <br />f) C y <br />��� <br />x H Cn <br />H O fn <br />• <br />everett <br />e <br />City of Everett <br />,� <br />r �� =,�s ���3 <br />� -� � � � <br />� �� _�;� s����� <br />,� C r � r <br />S <br />M . w fl <br />W <br />Sewer Application �ar�' Pex _rr�t _:_ , I <br />,� : � r, <br />� ti'-����.��=1'::�`v-_�'-i <br />N0. 27�JZa. DATE' P��'•, . ,S�J399e <br />Service Address . Utility Account <br />Billing Address , <br />City, State, Zip � <br />pw�er (Mortgagor) <br />Billing Name <br />Co�nection By <br />Address ��-- <br />Phone_�,.id�a - <br />DESCRIPTION: <br />Lot Block <br />Plat <br />Unplatted Description <br />Type Permit: <br />Remarks: <br />IMPORTANT! <br />CALL 1$00-024•5555 48-HOURS <br />PRIOR TO DIGGING <br />CALL 259-8811 FOR INSPECTION <br />SEE SKETCH ATTACHED <br />Permit <br />CHART <br />To ro�T��c �-�:�` z— <br />Connection Chargels) , <br />Total Fee , <br />Utility Aevclorment Fee Ord. 11'l1-85 <br />water 179.00 <br />s ■erer 47�.00 <br />� 650.00 <br />, � i // <br />Signed �' <br />cu:rome. <br />Sewer District Bond izr <br />Monthiy Sewer <br />Monthly Sewer Constr. <br />Trunk 395 00 <br />Laterel 3'�0 00 <br />Abutting Lot Line <br />N, S, E, W <br />Approved By �PxED R rHs�L <br />City En9mecr <br />Issued By SwY Ruaaen _ <br />. � <br />� o - �: <br />Inspection By_ <br />Oate Inspected � / � /�/� <br />No. 27�21 <br />I�SP[CTION <br />