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everen <br />e <br />City of Euerett <br />Sewer AppYication and Permit <br />C�ART <br />SE•r�T To cNH.e%��v� <br />NO. �`5`�G`9 DATE x�reh ls. 1486 � <br />Service Address 10609 - 4th Dr SE Utility Account No. <br />Billin� Address 17018 - 15th tiE <br />City, State, Zip_ Bsatll�. 1fA 98155 <br />Owner (Mortgagor) lwtoo Ooastractim <br />Billing Name 8ar <br />Connection By g+r <br />Address- '_7018 - lSth t�, S�attl� <br />Phone �63-0316 <br />Permit <br />Connection Chargels) s�e_on <br />Tutal Fee 3n_oo <br />Special F�as, Ordin�np 1171-85 <br />Wabz 179.00 <br />8�wr 171.00 <br />•�" :650-�, �; ��` / "�-- <br />Signed .+' '' %' /' <br />cu:tomer <br />/� <br />DESCRIPTION: Sewer District <br />Lot �y Block <br />Plat �d.� Zaee Monthly Sewer Service <br />Unplatted Description Monthly Sewer Constr. <br />Type Permit: <br />Remarks: <br />IMPORTANT! <br />CALL 1�800-024•5555 48-HOURS <br />PRIOR TO DIGGING <br />CALL 259�8811 fOR INSPECTION <br />SEESKETCH ATTACHED <br />Abutting Lot Line <br />N, S, E, W <br />Approved By ��n � �rtne�r. <br />Ciry EnBineer <br />ISsu2d By turvirw* Me�iwnel <br />Inspection By� �_ <br />Date I nspected i/ <br />`��`�N`o�. 25529 <br />IiVSf CCTIOf�: <br />