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CHART N0. <br /> � everett� ' <br /> � �i po�r� 8-3r-�1 <br /> I <br /> City of Everett � : <br /> � ' 7c ' <br /> (, <br /> Sewer Application and Permit � � <br /> N0. 24029 DATE _ July 7, 19i1 1 . <br /> t'-': !- <br /> 116 Veralenc Hay 6.W. 76082-7 <br /> Service Address —_ Utility Account No. <br /> 816 S.E. PAarett Mall May permit Fee 30.00 <br /> Billing Address <br /> 130.00 <br /> � City,State, Zip gv�rett, Hashinqton 9B]04 Connection Chargels) <br /> � Itillia Homua 30.00 <br /> Owner (Mortgagor) Total Fee <br /> Billing Name <br /> saoe <br /> Same <br /> ConnEctiun By � �� <br /> Address Signed <br /> �C <br /> Customer <br /> Phone j55-4492 � <br /> DESCRIPTION: <br /> Sewer District 36 Bond III <br /> � Lot �'� Block 5.10 � <br /> Veralane £etatee NonthlySewerService I <br /> Plat __ <br /> I Unplatted Description_ Monthly Sewer Constr. <br /> � Trunk �•Z� 330.00 <br /> � Type Permit: ti�r Connnction <br /> Lateral <br /> Remarks: Abutting Lot Line <br /> N• S- E� W— -- ft. <br /> ApprovedBy �• n. Thenl I <br /> Ciry EnBinecr <br /> � F.. IIond �I <br /> Issued By I <br /> I <br /> Inspection By � (�-�`--� I, <br /> Date Inspected � �U�—y � JU�� � <br /> SEE SKETCH ATTACHED No� 24029 <br /> I <br /> RdSP[C(ION I <br />