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CHART �0. <br /> everett ' <br /> e T� �ST�� <br /> �' S -�0-90 <br /> City of Everett � $ � g <br /> � G � � <br /> Sewer A� i4Qtion and Permit <br /> , � ^ <br /> � -, <br /> ��'.v . � �� u <br /> 277Q� = "� " � <br /> N0. DATE �..—.�,s+i�?_STioan <br /> Service Address 10�08 — lst or s� Utility Account No. <br /> Billing Address ■ Permit Fee 3p,�� <br /> City,State, 2ip a..�+.tt wa 9�es Connection Charge(s) — <br /> Owner (Mortgagor) r r,�. • . ot.en Total Fee 3p.,�� <br /> Ordinenp 1171—BS <br /> Billing Name s�° snwer only 471.00 <br /> Connection By, e..� <br /> Address Signed <br /> Customer <br /> P�10:�d <br /> DESCRIPTION: Sewer District <br /> Lot Block Monthly Sewer Service <br /> Plat <br /> Unp�atted Description Monthly Sewer Constr. <br /> Trunk <br /> Type Permit: <br /> Lateral <br /> Remarks: <br /> Abutting Lot Line <br /> N, S, E, W ft. I <br /> Approved By IA1t1� CRl►N!'ORD <br /> Ciry Engineer <br /> IMPORTANT! <br /> Issued By T R�claaell <br /> CALL 1-800-024-5555 48•HOURS <br /> PRIOH TO DIGGING <br /> CALL 259�8811CFOR INSPECTION <br /> � � <br /> Inspection By � <br /> Datelnspected ���"�Pl� <br /> SEE SKETCH ATTACHED N�• ����� <br /> IN:PGCTIGN <br />