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CHART NO.__ <br /> everett <br /> � <br /> City of Everett <br /> Sewer Application cnd Permit <br /> NG. ����� DATE _ Septemhor 12 19Si9 <br /> Service Address Utility Account No. � <br /> Permit Fee <br /> Billing Address ' <br /> City,State, Zip�}�.� Connection Chargels) <br /> Owner (Mortgagor) Total Fee , <br /> Utility D�wloFsent Fae Ord. 1171-65 <br /> Biliing Name �eates 174.00 <br /> swaz 471.00 <br /> Connection By 650.00 <br /> Address_ Signed � � - <br /> 'q�°^j'w't}�. 4:Ri�Yf f10tY1N?ES�_ tI; t <br /> ; <br /> Phone iyY�10�7�la <br /> DESCRIPTION: Sewer District ��Il�th �pd� �;� <br /> 1177-5 4:,5p.(b1 <br /> l.ot �__ �_T-sf -� B�ock 2S1 Monthly Sewer Servi�l�^"� — <br /> Plat �9.IN'i 44E3�.W <br /> Unplatted Description_ Monthly Sewer Con�e(la; >5:i.10 <br /> 19 C!1 9b.i.f�(1 <br /> Trunk Rr �i ru en� -n <br /> Type Permit: �� `�M:�� �'+•`� <br /> Lateral � ccru :i� rv+ <br /> UhVN'! f�U.�10 <br /> Remarks: Abutting Lot Line .".0(k]�.i8�1 <br /> N S E W u'T ^il •s1Uti i °S3 ft. <br /> CU[Nrilb;2�i <br /> 11�17I1: SeJ0.U0 <br /> CHI.i{; 3'.�'tit,::+� <br /> ApN�oved By ALPRBD R. TI�AL__ <br /> City EnO�ncer <br /> IMPORTANT! Issued By Susv FtAuaen <br /> CALL 1-800-024-5555 48•HOURS <br /> PRIOR TO D�GGING � <br /> CALL 259�8871 FOR INSPECTION I �i'" <br /> Inspection Ly �`�`/ <br /> Date lnspected � `l <br /> SEE SKETCH ATTACHED N0. 2�316 <br /> Gl�:'f'cCTIQ;J <br />