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everett <br />� <br />City of Everett <br />Sewer /�pp�ication and Permit <br />CHART N0. <br />_��� _1� �; _ i,. �� _ -. _ ,_ . <br />N0. �v��$ DATE tsav 5 1986 � <br />Service Address �����— Utility Account No. <br />--z:�:^3� e�.. <br />Billing Address_ , <br />City, State, Zip �ttle <br />Owner (Mortgagor) ' � , <br />Billing Name <br />Connection By <br />Phone <br />iDESCRIPTION: <br />Lot �� Block <br />Plat ���=y___-- <br />Unplatted Description <br />Type Pcrmit: <br />� Remarks: <br />IMPORTANT! <br />CALL 1�800-024-5555 43-HOURS <br />PRIOR TO DIGGING <br />CALL 259�8811 FOR INSPECTION <br />SEE SKETCH ATTACHED <br />Permit Fee t�.D� <br />Conneciion Charge(s) _�� �0 <br />Total <br />Oz3inence 1171-65: <br />179.00 <br />471.00 <br />650.00 ' <br />Signed ' <br />Cuswmer <br />Sewer District �a TTT <br />Monthly Sewer <br />Monthly Sewer Constr. <br />Trunk <br />US/:'=i1'u, .:114('ii IliifNi!i(�7.'.6 i;l: <br />Lateral <br />i i Ui7li 7 7'9 i i <br />Abutting Lot LinetA.l•U Sy S7.tti <br />N S E VJftk:(i J�iS.I?D ft. <br />u . .��i. <br />u !',r�'H a3.a1 <br />I ": fIi '-tJ.Cq <br />,1,,,�'.� ;�U.lu) <br />I�i';- 6-1_I <br />Approved By .�y�„ � �i�'` <br />Gty Engineer <br />,.i i� u):..,,.`, d: <br />Issued By a�yj�� iy�f�Li��t�� <br />!i'�1-', 5c<dl.idl <br />I:i lEL l . l i.4.L.:AI <br />c.. � <br />Inspection By � /`� <br />Date Inspected � - �-� - ��% <br />No. 26658 <br />I �^�:: �(' I'� ;' I I OP: <br />