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, <br /> CHART NO.--- -- <br /> I everetl y � <br /> � .� "-T-t� �s�-1 u 4, <br /> � 5- y9-9� <br /> � � � <br /> City of Everett =- <br /> i n �c: r. �. <br /> LL .d <br /> :J <br /> Sewer ��►pplicat��and Permit <br /> 'a4 ` <br /> I No. 27537 , DATE Anrc� 2_ lo��� — <br /> Service Address 11119 - 3rd Ana �' Utility Account No. <br /> Billing Address Permit Fee . � <br /> City, State, Zip Connection Charge(s) <br /> Owner (Mortgagor)_� Total Fee 3D 0� <br /> Billing Name Sn* <br /> Connection By A•�n,;�------ <br /> qadress Signed c�srome� I( I <br /> Phone I <br /> DESCRIPTION: Sewer District — <br /> � Lot Block Monthly Sewer Service <br /> Plat <br /> � Unplatted Description _Monthly Sewer Constr. <br /> — Trunk_ <br /> Type Permit: �� �p�tpe^tion � _ <br /> Lateral <br /> Remarks: Abutting Lot Li�e <br /> N, S, E, W ft. <br /> Approved By �+-���' ��LR-1�iGAL <br /> City nBincer <br /> IMPORTANT! y��� I <br /> Issued BY' <br /> CALL 1-800d24�555 48-HOURS <br /> PRIOR TO DIGGING <br /> '// <br /> CALL 259at811 FOR INSPECTION l q G ) / <br /> / <br /> Inspection By ` � <br /> Date lnspected �'� <br /> SEE SKETCH ATTACHED No. 27537 <br /> ir�i rr.�rrie;� <br /> � <br />