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everett <br />� <br />City of Everett <br />Sewer Application and Permit <br />CHART N <br />� <br />�,. ,_ f �-, �ir:: : , <br />-.i.�.._ <br />27112 <br />NU. DATE �,�����9$� <br />Service Address � Utility A�count hJo._ <br />Billiny Address g�� Permit Fee <br />City, State, Zip� _•o-e. � tiA�&284 Connection Chargel <br />Owner (Mortgagor) ��aroo �u��siae Totai Fee <br />Billing Name z� (ttility Develo�nt Fee Ord. 1171-80 <br />altx aexrtr 471.00 <br />Connection By �..�M�ta • <br />Phone <br />DESCii1PTION: <br />Lot <br />Plat <br />Unplatted Descr <br />iype PermiL• <br />Remarks: <br />Block <br />IMPORTANT! <br />CALL 1�500-024-5555 48-HOURS <br />PRIOR TO DIGGING <br />CALL [59-8811 FOR INSPECTION <br />SEE SKETCH ATTACHED <br />_ Signed <br />Customcr <br />Sewer <br />Monthly Sewer Service <br />Niunthly Sewer Constr. <br />Trunk �;,.��'E; � , . -`�.,�r. �!i+ii;ilVn,r;r., tl.l:�. <br />Lateral E1100�7fi:.' <br />. :� : • 3 ���U.t <br />Abuttiny Lot Line 21�`I,' �'��'Or� <br />N S E W�,HEI,1. ti:d11.�U) ft. <br />AP�]fOVCf� BY _ AT.FRFII R 7'lIIITT <br />City [ngmcer <br />Issued By cnay a +qen <br />r --- / <br />Inspection By--�'�` � <br />Date Inspected � -� � - � <br />No. 27112 <br />I�'.�Pci:il!'`; <br />