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everett <br />�� <br />City of Everett <br />Sevver Application and Permii� <br />CHART NO. <br />S�,v7- Tr, Cf/R�PTiA/� <br />5-�6-87 <br />N0. L�O�`� DATE — L� <br />+nuarY . <br />Service Address Utility Account No. <br />Bi��ing Address <br />City, State, Zip , <br />Owner (Mortgagor) , a c n, c. <br />Billin� Name�.. <br />Connection Rv <br />Address <br />Phone_ <br />DESCRIPTION: <br />lot Block <br />19 <br />Permit <br />Connection Charge(s) . <br />Total F <br />Special Utilitq Fee, Ord. 1171-85: <br />�.c v�.eo � <br />�e`{a 471 � <br />i '' S6 . p0,(% • <br />S�gned � � <br />jCus�omer <br />: � <br />Sewer District <br />Hon str. ct zix <br />h1onthly Sewer Service <br />Plat <br />Unplatted Description � Monthly Sewer Constr. <br />Type Permit: <br />Remarks: <br />lMPORTANTf <br />CALL 1-900-024-555546�HOURS <br />PRIOR TO DIGGING <br />CALL 259-8811 FOR INSPECTION <br />SEE SKETCH ATTACHED <br />Trunk <br />Lateral , J, i� <br />� <br />Abutting Lot Line��y�� �,p <br />N. 6. E, W1Y�u �45`: iui ft. <br />Ft_(�i 445.b0 <br />iiF:l:l l :�.`.ui.' i[) <br />{'1_.II CFI S8';. i0 <br />C Sk1::i Sl.:H) <br />Approved By E ` ' " `� <br />��_ � npineerg..O.lfJ <br />k�AlOL6(,I5 <br />Issued By �y`j}� fi ��j,,f�S <br />C.i�U I I I 9-i:a). tXl <br />i )1� z t.�),IXI <br />2t.0. W) � <br />�j� •�.' . <br />Inspection By_ {� <br />Date Inspected_ ✓/ 3� _ <br />INSP�C-i IOf�� <br />No. 26015 <br />