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everr� <br />e <br />City of Everett <br />Sewer App�ication and Permit <br />2 5 5 2 7 Maroh 19r 1986 <br />N0. DATE _ _ <br />Service Address 10615 - 4th Dz SE Utility Account <br />Billing Address 17018 lSth 116 <br />City, State, Zip 8eattle, pti 98155 <br />Owner (Mortgagor) �� C«utruction <br />Billing Name $� <br />Connection Bv S� <br />Address <br />Phone �3-0317 <br />DESCRIPTION: <br />Lot 10 Block <br />CHART <br />s e.�r ro c.v9�T.,�,� <br />5:�2-C6 <br />Permit Fee 30•� <br />Connection Chargels) 310.Q0 <br />Total Fee 30.00 <br />ap�cial Swar Faes, Ordin�ao� 1171-85 <br />Mabr 179.00 <br />G�wer �;1.00 <br />650., 0 � <br />!- � ,' "/�. <br />� <br />Signed '`� � /� , _ <br />cu:romer <br />Sewer District Houd I7I <br />Plat �.�.r r..... Monihly Sewer Service <br />Unplatted Description Monthly Sewer Constr. <br />Type Permit: <br />Remarks: <br />IMPORTANT! <br />CALL 1�800-024-5555 48-HOURS <br />^RIOR TO DIGGING <br />CALL 2599811 FOR INSPECTION <br />SEE SKETCH ATTACHED <br />Abutting Lot Line <br />N, S, E, W <br />Approved By �� a TH� <br />Ciry Engineer <br />Issued By �4uaG lleL�od <br />Inspection By <br />Date lnspec[ed ��� ��i�0 <br />rvo. 25527 <br />IVSPECTION <br />