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everelt CHART NO. <br /> e <br /> � City of Everett <br /> �.v%�i'� c�'h'c—i.iCi //-/9-8G <br /> Sewer Application and Permit <br /> No. 25948 DATE _rev�shw� 3 toA6 <br /> ��is <br /> Service Address_��y��� Utility Account No. <br /> Billing Address Permit Fee 2�� <br /> City,State, Zip Connection Cherge�s) <br /> Owner (Mortgagor) Total Fee�.59 <br /> Billing Name <br /> Connection By <br /> Address Signed_ %� '� �trr�iaz-�a.p�� �N� �x <br /> Customer � <br /> Phone MCDp^5948 <br /> DESCRIPTION: � <br /> Sewer District_ +�o�+ IB 8B <br /> Lot��_ Block�_ <br /> Plat_ Manthly Sewer Service _ <br /> Rl�t �! ErKat! <br /> Unplatted Description _Monthly Sewer Constr. <br /> Type Permit: Trunk <br /> Lateral <br /> Remarks: �� 5�� Q� <br /> / Abutting Lot Line <br /> l�1 �:.r� (oew�ho-: le�+.c� N, S, E, W ft. <br /> 11� IP P�. ••_ <br /> _. J� <br /> Approved By <br /> City EnOinee, <br /> IMPORTANTI <br /> Issued By <br /> CALL1$OOd24.555548-HOURS U! � �IIM11 <br /> PRIOR TO DIGGING <br /> CALL 259$811 FOR INSPECTION <br /> Inspection By <br /> Datelnspected <br /> SEE SKETCH ATTACHED Np, Z594S <br /> INSPECTION <br />