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-s <br />everett <br />e <br />City of Everett <br />Sewer Application and Permit <br />No. 26100 DATE .3- 23- S7 <br />Service A ress�5 1 g I S �a �YAtNtA Utility Account <br />Billing Addr Permit Fee_ <br />City, State, <br />Owner ( <br />Billing Name �+ <br />Connection <br />Address r <br />DESCRIPTION: <br />Lot Block <br />Plat <br />Uoplatted Deccr <br />Type Permit: Pr DR I Y <br />Remarks: S <br />yiL p Y <br />IMPORTANTI <br />CALL 1 800-424-5555 48-HOURS <br />PRIOR TO DIGGING <br />CALL 259-8811 FOR INSPECTION <br />SEE SKETCH ATTACHED <br />Connection <br />Total <br />Signed <br />Customer <br />Sewer District <br />Monthly Sewer Service_ <br />Monthly Sewer Constr. <br />Trunk <br />Lateral <br />Abutting Lot Line <br />r N, S, E, W <br />Approved By <br />City Engineer <br />Issued <br />Inspection <br />Date Inspected_- i 7' S7 <br />No. 26100 <br />CUSTOMER COPY <br />