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Ien <br />City of Everett <br />Sewer Application and Permit <br />No, 26100 DOTF, 3- 23- 87 <br />Service Address-0 I t _ (� q I_ 5 �y �/1 I.Vi A Utility Account No <br />Billing Address <br />F i rit Fee__ <br />City, State, Zip <br />Connection Charge`; <br />Owner (Mortgagod— <br />_ Total Fee <br />Billing Name <br />Connection By <br />Address <br />Signed <br />Phone <br />DESCRIPTION: <br />Lot Block <br />Plat <br />Unplatted Description <br />Type Permit: Qp <br />Remarks: <br />NV " C. J <br />IMPORTANT! <br />CALL 1-800-424-5555 48-HOURS <br />PRIOR TO DIGGING <br />CALL 259.8811 FOR INSPECTION <br />SEE SKETCH ATTACHED <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 />Cary Engineer <br />Issued <br />nspection By <br />)ate Inspectea_� <br />C:JSTCn9S1i CCPy <br />NO. <br />