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. <br />everett <br />e <br />City of Everett <br />Sewer Application and Permit <br />%� r ;; ,. � February 28, 198E <br />NO. �... , l DATE <br />Service Address 1617 Virainia �j/2_ <br />Billi�g Address <br />City, State, Zip <br />Owner (Mortgagorl <br />Billing Name � <br />Connection By City of Sverett <br />Phone <br />DESCRIPTION: <br />Lot Block <br />Pla: <br />Unplatted Description_ <br />Type Permit: <br />Remarks: 7- , . �-•-L/ ��.. � [:.. ,. <br />_ �._�_ e.`c� —._ .,_ c <br />IMPORTANT! <br />CALL 1-800-424-5555 40-HOURS <br />PRIOR TO DIGGING <br />CALL 259-8811 FOR INSPECTION <br />SEESKETCH ATTACHED <br />CHART <br />Utility Account No._ <br />Permit Fee NO <br />Connection Charge(s1. <br />Total Fee___-� <br />Signed_ <br />Sewer District <br />Monthly Sewer Service. <br />Monthly Sewer Constr. <br />Lateral <br />Abutting Lot Line <br />N, S, E, W <br />Approved By Alfred R. Theal <br />Ciry Engineer <br />155ued By Margaret McLeod <br />.s �) �- ,, � — <br />Inspection By _' r� �i'' �'/�•�� <br />Date Inspected �% '� ' ��' <br />N 0. 7 �� tl : <br />