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CHART NO. <br />svcreft <br />e <br />City of Everett <br />Sewer A�pplication ar�d Permit <br />rio. 27664 DATE __ u••^h oi i9oo <br />Service Address � i�n� 1� n� �m Utility Account N <br />Billing Address Permit Fee . <br />City, State, Zip�itrus oew�n�_ Connection Charge�s) <br />Owner (Mortgagor) Total Fee . <br />Billing <br />Connection By *� <br />Address <br />DESCRIPTION: <br />Lot <br />Plat <br />Unplatted Descr <br />Type Permit: <br />Remarks: y� <br />Block <br />IMPORTANT! <br />CALL 1-800-024-55F5 48-HOUflS <br />PRIOR TO DIGGING <br />CALL 259�8811 FOR INSPECTION <br />SEE SKETCH ATTACHED <br />—�-p tx�s; rt��. <br />5_��-��, <br />U�;i.'j;;,�l il):;:'rYCS IrJ!?r'RU::v' <br />r <br />iil'�OlL7LG4 <br />�r�� s-;u.ou <br />uitil: : 'tt.�;il <br />Signed <br />cu:tom <br />Sewer District <br />Monthly Sewer Service. <br />_ Monthly Sewer Constr. <br />Abuiting Lot Line <br />N, S, E, W. <br />� <br />Approved By �";� �• T''W�' — <br />C�rr Engineer <br />Issued By J RockM�ell <br />`i� -� �%�'7� �/' i � <br />��e`��°�'" <br />Inspectia� By <br />� <br />�' � `' J <br />Date Inspected <br />No. 27664 <br />li�:'i''EC I IOf� <br />