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cvcrett <br />� <br />City of Everett <br />A��Z�.a� � <br />1�DS� t� n <br />�l-ao-8� i.yw <br />Seanrer Application and Permit <br />8/17/bl <br />i <br />.:ti ��;�r ,��:. <br />i CALL 48 `�011RS <br />� BEFORE Y��U DIG <br />j 1-800-562-6478 <br />i.t'. 2�O�J8 DATE _ — �_ <br />'�.�.�rviceAddress 5215'y South 4th UtilityAccountf�:.� <br />5215 South 4th na�� <br />ilingAddress PermitFee_�__.__ ____ _ <br />Everett, Wa. 98203 <br />;iry, State, 2ip Connection Ch:�rge�s) <br />none <br />)�vner (Morigagor) Richard A. Caudle T„� ,� `,:,, <br />�.S�.Iling Name Same <br />��-.�����.�.:;tion By '����X City of EveretP <br />.�..�?iress <br />. i� ��ne_ 252-0793 <br />� �; SCRIPTION: <br />i nt _ Block <br />Piat <br />Jnplatted Description __ <br />i vPe Permit: New Connection <br />f;emarks: ------------ <br />i _ i, <br />.� " „+ �s'➢1,�)..' <br />i <br />,u <br />Sewer Distri� <br />Monthly Sc� : <br />N�n[hly Sec�� � <br />Tru <br />��t��� ,, _ <br />Aluittim; Lnt Lii�•� <br />�L� . . . ,!: _ <br />� /1�7(11�OLLC� �)'_ <br />Cny Engmeer <br />� <br />i-ir:i�..'IIC. ... n,�•��d <br />i� � <br />i . ���L�� !/�s�_� � . . . . <br />C�. :'.,,. ' L� . '.f't_;, I � U`- �.'f�Y <br />_ � <br />� Inspectiun L;y--����--Y—_'. . _ <br />_ _ _._ . Date I nspected �" /��� <br />�:t[ SKFTCH ATTACH[D N�. � � <br />