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CHART NO. -- <br /> everett <br /> e � <br /> City of Everett � � �p �y�i � � p� �p � �' �,� <br /> .-+ � C^ 1-S e�1� .�iN O MC�yv C <br /> � K o0 w� tR M � N M .�r <br /> Sewer Applica�ion and Permit P_,� � � � � � � � � � � ; <br /> 26238 � � � � � " "' ��� � � � � <br /> NO. DATE ��y, +oa�— <br /> Service Address +�+�����— Utility Account No. <br /> Billing Address . Permit Fee . <br /> City,State, Zip �ODIIa°' � Q8020 Connection Chargels� <br /> Owner (Mortgagor) . Total Fee . <br /> Billing Name Special otilitp is�, Ord. 117Y–SSs <br /> ■t vatnr Sz24.00 <br /> Connection By <br /> Address Signed _ <br /> Cus�omcr <br /> Phone �71-5131 <br /> DESCRIPTION: Sewer District —_ <br /> Lot � _ Block <br /> Monthly Sewer Service — <br /> Plat �— <br /> Unplatted Description Monthly Sewer Constr. <br /> Trunk __ <br /> Type Permit: <br /> Lateral <br /> Remarks: <br /> Abutting Lot Line <br /> N, S, E, W ft. <br /> Approved By <br /> � <br /> IMPORTANTI <br /> Issued By µ�y�F�L � ��L�od <br /> CALL 1�800-024-5555 48-HUURS <br /> PR!OR TO DIGGIM1G <br /> CALL 259�8811 FOR INSPECTION C2��. <br /> Inspection By <br /> Datelnsp�..ed 9'1'8'g � <br /> SEE SKETCFi ATTACHED N0. 26Z3H <br /> IN�PCCiION <br />