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everen <br />e <br />City of Everett <br />Sewer Application and Permit <br />CHART <br />NO. 26558 DATE march. L <br />,y � 19ee <br />Service Address 2401 Aer 2etA 1`a. Utility Account No. <br />Billing Address s.�. <br />City, State, Zip tw =tt; ri gR�n1 <br />Owner(Mortgagor) AXMa, jda <br />Billing Name a.... <br />Connection By_ _y�Ltj r 00uN <br />Address 11911 d.. go — <br />Phone 352 7534 <br />DESCRIPTION: <br />Lot_ Block <br />Plat <br />Permit Fee— %0.00 <br />Connection Charge(s) <br />Total Fee_ 30 00 <br />Signed ' [.• lf� <br />Cusco r <br />Sewer District <br />Monthly Sewer <br />Unplatted Description Monthly Sewer Constr. <br />Permit: <br />Remarks: <br />Lateral <br />Abutting Lot Line <br />N, S, E, W, <br />Approved By ALFm R. <br />1.►' <br />IMPORTANTI i <br />CALL 1-800424.565548-HOURS Issued By — <br />PRIOR TO DIGGING <br />CHEIi( 610.00 <br />CALL 259-8811 FOR INSPECTION <br />Inspection By <br />Date Inspected _ <br />SEE SKETCH ATTACHED NO 29558 <br />INSPECTION <br />