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i <br /> � <br /> CHART NO. <br /> everett � <br /> e � <br /> City of Everett � <br /> Sewer Application and Permit � <br /> N0. 26173 DATE _ �Y �. i987 <br /> Service Address 10220 - 3zd Ave SE � Utility Account No. <br /> Billing Address 11400 SF. 8th, 5uite 235 Permit Fee 3a•�� i <br /> Dellevue, NA 9A006 Connection Charge�s) 6121.11 tor total of <br /> City,State, Zip Fulton'a Landinq <br /> I Owner (Mortgagor) � Crow I�estern Total Fee_ 1� 30.00 Connection� <br /> Special IItility Feca, Ord. 1171-AS for whole <br /> Billing Name 5a� project: watar 28507.60 <br /> eeaer 75156.40 <br /> Connection By T.C.R. Seattle 103,664.00 <br /> � Addre�s Signed c�:�o�„e� <br /> Phone 45�-9030 <br /> DESCRIPTION: <br /> Sewer Dis[rict_ �nd III _ <br /> Lot Block MonthlySewerSerUiE�G;t;; �:Uil'ri (i�ta1��:.15 ;E : ' <br /> Plat <br /> Unplatted Oescription See attsched Monthly Sewer Con��»'�' <br /> Gt1iG 'iltiT;.`,,U <br /> ,� �1�n�a i-ndS q Trunk � SF17785.201.xl <br /> I TYPe Permit: : _ :�. ;it�.!ni <br /> � Lateral ������•91 <br /> _ . . y;u.«u <br /> Remarks: 1 Sever Fer�nit! � bvina isaued�_ t#�1II 'bf�i:t:.11 <br /> Abutting Lot Liney��i � ��.:�1•,� � <br /> ��r G33 ft. <br /> 3�o f m i r � r- a� � «���w N� S� E� W�`="tnmtTz�---- <br /> c:N�1� i1ii-� s iilixiil.[0.� <br /> - CI4L'LI; :`.'o::�r7.'i t <br /> i Approved By r.eRt-� e. ni�1+r. -- - — I <br /> Ciry Enqineer <br /> IMPOR' • NTI <br /> Issued By MdZRAYP}' c_ Weleod_ <br /> CALL1-800�424�555546�HGURS 1f1'y5;'fYi :':0'�I'Rlk�(U�1H761.0 tii�f� <br /> PRIOR TO DIGGING � � <br /> ��) 4 .'pl'ij ^ i <br /> CALL 259•8817 FOR INSPECTION +��) 4�t`i 'iF .�SO <br /> Inspection By ��' '` <br /> :�ii }� <br /> Date I nspected � '� <br /> SEE SKETCH ATTACHED <br /> r�o. 26173 � <br /> I f`::'�P1 ;;�i IOi� � <br /> I <br />