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CHART NO. <br /> everetl <br /> e �_,g_4 <br /> Cisy of Everett �_F��'T Tc� C�1/�/_:iti�r <br /> � ��- � 7 <br /> S� �ver Application cnd Permit <br /> No. 25955 pATE Nnv�ehnr � ,4RR <br /> Service Ad�ress ?�21 W erekrt Ave Utility Account No. <br /> BillingAddress '^^, "-_n�� PermitFee 3�nr, <br /> City,State, Zip Frerelt NII 9A243 Connection Charyels) �p�t <br /> Owner (Mortgagor) � r,...�r..���Nen Total Fee 3g,�� — <br /> BillingName c s• Speci�l Utillty Fee Ord. 1171-85 <br /> Hate� 224,OQ <br /> Connection By <br /> Address Signed cwn�„x�::, �:. .rn ���. n:s..>.._ kt <br /> Phone ��� �I3 :v(x��t)1?qOlt <br /> 7.fa 4'.i';4.:AI <br /> DESCRIPTION: Sewer Distr;ct ��_� <br /> Lot � Block Monthly Sewer Ser F���{� 4`y:`A� <br /> Plat <br /> Nlonthly Sewer Con�t�;�`��� Et'r�� <br /> Unplatted Description E �t;�{ ;1$,W.I <br /> Trunk �'ry'�`'� �'`�'��� <br /> Type Permit• New ConnKtton "`�y � <br /> Lateral `'F�' }��'�� <br /> �1-v i��Ch.l <br /> Remarks: Abutting Lot LineF�S`SM1 <br /> 4i1C1' iN1.00 ft <br /> N� S� E� W .., �. . - <br /> Approved By <br /> i V n9�ncor <br /> IMPORTANT! <br /> ISSued By ���e G�inein <br /> CALL 1�800-024-5555 48-HOU RS <br /> PRIOR TO DIGGING <br /> CALL 259�8811 FOP. INSPECTION /'/��— <br /> Inspection By ��� <br /> Datelnspected S�� �� <br /> SEE SKETCH ATTACHED No. 25955 <br /> li�fi(`FC i ION <br />