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everett <br />�e� <br />City of Everett <br />Sewer Application and Permit <br />CHART N <br />ged ft psl,.t, <br />7-zr, -q <br />NO. 27116 DATE 1069 L� <br />Service Address 2631 W Marine vtntu nr_ Utility Account No — <br />Billing Address SW�-- <br />City, State, Zip Everatt_ WA 92201 <br />Owner (Mortgagor) *+t,� AnM nett <br />Billing Name save <br />Connection By._ <br />Address S � <br />Phone 252-7500 — <br />DESCRIPTION: <br />Lot 10,10A, 11 Block 671 _ <br />Plat Plat of Lverett <br />Unplatted Description <br />Type Permit: <br />Remarks: <br />IMPORTANT! <br />CALL 1-800.424-5555 48-HOURS <br />PRIOR TO DIGGING <br />CALL 25Mf 11 FOR INSPECTION <br />SEE SKETCH ATTACHED <br />Permit Fee 30_00 _ <br />Connection Charge(s).__3onr <br />Total Fee 30-c) _ <br />Signed <br />cis —tome. <br />0129/84 <br />12=23pm tNIMB f W <br />Sewer District_— <br />f:OM121534 <br />Monthly Sewer Serwcetph--,, <br />Monthly Sewer ConstrSKl! <br />$1S.W <br />ir'VN'1 <br />335.00 <br />Trunk <br />'XWO: <br />430.00 <br />Lateral <br />l <br />WILT: <br />160.00 <br />Abutting Lot Line rI?ITi; <br />a<,vS.IFJ <br />N, S, E, W- — — <br />ft. <br />Approved Ry__ALFRED R. TILE" <br />City Engmee, <br />Issued By Susy Haugen <br />Inspection <br />Date Inspected <br />INSPECTION <br />NO. 27116 <br />