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evQretl <br />e <br />�� <br />� <br />CHART N <br />City of Everett � �' = <br />c; <br />��, - <br />w <br />Sewer Applicction and Permit ��. �� �. _ <br />:, � � -� <br />� J � <br />NO. Z969S DATE ��t, 3900 '"' � _, . 'e <br />Service Address 1�YQ �+h �� v <br />Billing Address �R�S �'+�� *1 *+� <br />City, State, Zip M.mei�la. � 9��� <br />Owner (Mortgagor�� ri � � <br />Billing Name <br />Connection By � L • �'m+ *surtlnn — <br />Phone GS4 6T]S (Tinq3�qt <br />DESCRIPTION: <br />Block <br />Utility Account No. <br />-� ('�(� � � 7� / S—S b <br />Permit Fee__ 30.00 <br />Connection Charge� <br />Total Fee 30.00 <br />Ordinance 1171-85. <br />sevsr oaly �OO.OJ <br />Signed � �j _ � �,; ,, <br />customer / <br />Sewer District <br />Monthly Sewer <br />Plat <br />Unplatted Description Monthly Sewer Constr. <br />Type Permit: <br />Remarks: <br />IMPORTANT! <br />CAL L 1�800-024•5555 48-HOU RS <br />PRIOR TO DIGGING <br />CALL 259-6811 FOR INSPECTION <br />SEE SKFTCH ATTACHED <br />Abutting Lot Line <br />N, S, E, W. <br />Approved By <br />i y �ngin M <br />Issued By�� ��.�,�---�� <br />Inspection By� ` <br />Date Inspected S Z� � <br />No. 26698 <br />��r��C I �nl'! <br />