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�\ <br /> CHART NO. k � �2�j — s <br /> everett , � � <br /> e ��sT� 3�Z� �eo <br /> �. <br /> City ot Everett <br /> Sewer Application and Permit <br /> No. 23527 DATE _�=ch 12 1980 _ <br /> 5119 Giaw Drtoe Utility Account No. 75898-7 <br /> Service Address — <br /> Billing Address F o Boz 1225 — <br /> Permit Fee 30.00 <br /> 677.50 <br /> City, State, Zip �arett, ba. 98206 Connection Chargels)_ <br /> gwr:tt I+ntery Club 30.00 <br /> Owr�er (Mortgagor) Total Fee <br /> Billing Name <br /> Eve=eYt ltotarY Club <br /> Connection By $A� <br /> Signed � <br /> /1d(�fC55 Customcr � <br /> Phone 259-9141 <br /> I DESCR�PTION: <br /> Sewer District �� HO'�d II <br /> Lot ZB Block Monthiy Sewer Servir,e 5.10 I <br /> � Plet vi v a.-ren <br /> I Unplatted Description Monthly Sewer Constr. I <br /> — Trunk 1.5.5 255.00 <br /> � Type Permit: NeM Connection Lateral 2•ZS 422.50 _ <br /> I <br /> � <br /> � Remarks: Abutting Lot Line <br /> N, S, E, W ft. <br /> I <br /> �'// � <br /> I APProved BY �• �arren I <br /> 'I �!ry Engincer <br /> `I �� E. Bond � <br /> Issued By -- , <br /> i <br /> �� �.�- <br /> Inspection 1" <br /> I Date Inspected. •3� y �U <br /> I SEE SKETCH A7TACHED N�� 23527 <br /> � <br /> IINSP[CTION <br /> ( <br />