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CHART <br />�vereri <br />� <br />City of Everett <br />To i3s-t.--�. <br />3-z� �1 <br />Sewer Appiicatian and Permit <br />NO. 26714 DATE June 2 19H8 L� <br />Service Address � �o�G +�_ ;� r_. Utility Account No. <br />Billi�gAddress +o�.���• �! <br />City, State, 2ip <br />Owner (Mortgagor) <br />Billing Name . <br />Connection By —�o.,, <br />Address �--� <br />Phone.-3s��, <br />DESCRIPTION: <br />Lot �a Block <br />Plat �..-<.. .b•+-,- <br />Unplatted Description <br />Type Permit: <br />Remarks: <br />IMPORTANTI <br />CALL 1�800�424-5555 48-HOURS <br />PRIOR TO DIGGING <br />CALL 259-8811 FOR INSPECTION <br />SEE SKETCH ATTACHED <br />Permit Fee 30 Oo <br />Connection Charge�s) 3'+n no <br />Total Fee <br />Speclal Otility Foo Ord. 1171-HS <br />water 179.00 <br />eewer A71.00 <br />, G50.00, <br />Signed <br />Cusromer <br />Sewer Dis[rict r j TII <br />Monthly Sewer <br />MonthlySewerCorretn)'i-2�;; i�uk;irrt OOihiNt'�'l.�i tFt> <br />Trunk "i iiu � i�li nn <br />C•Lfli i•i:',.l)d <br />Lateral f7 fv #H'�.1u7 <br />flf_f,H 'S4.!il <br />Abutting Lot Line�' '�'�`�� ''�•'a� <br />N S E WI.'i'1'H 41�.tui ft. <br />Ut?,4��' 'f:: .L�1 <br />?in7:1. �14 <br />� f � � i., ::0.(r,) <br />i �!'.•; i 1 ..:U.U!3 <br />Approved By � I�RT'�n x"' �'�a'ny <br />} <br />�61t�' ngih r <br />l!iill_i, ^C•U.1)l� <br />��i�! � n ilt�t.`:.{1 <br />Issued By ��•�; uA�!g <br />Inspection By <br />Date Inspected <br />No. 26714 <br />li:"'�°::�;il0f � <br />