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evere" <br />0�� <br />City of Everett <br />Sewer Application and Permit <br />N0. 27305 305 DATE sei] mtur 5. <br />Service Address <br />Address��„gl—Ttzn-n��— — <br />Billing Address_�5;�gyp1 <br />City, State, ZipzyQ <br />Owner (Mortgagor)_RISE z — <br />Billing Name <br />Connection By <br />Address gy— <br />Phone_--3�Tq� <br />DESCRIPTION: <br />Lot 1t_v Block—t- <br />oi„ Plat of Lovell <br />Unplatted Description <br />'ype Permit: <br />Remarks: <br />IMPORTANT! <br />CALL 1-800-424 5555 48-HOURS <br />PRIOR TO DIGGING <br />CALL 259-8811 FOR INSPECTION <br />SEE SKETCH ATTACHED <br />CHART NO. <br />V(U/yo <br />Utility Account No <br />Permit <br />88SS888 <br />ui .r vi o <br />s <br />�Iij'=W <br />Connection Charge(s) hione — <br />Total Fee <br />Sinned <br />Sewer District nond TT <br />Monthly Sewer Service. <br />Monthly Sewer Constr. <br />Trunk <br />Lateral_ <br />Abutting Lot Line <br />N, S, E, W_ <br />Approved By m rnym R rtn: nT <br />City Engineer <br />Issued By c"r <br />Inspection By <br />i' <br />Date Inspected <br />NO. 27305 <br />INSPECTION <br />