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CHART NO. <br />even�tl <br />� <br />City o! Evarett <br />Sewer Applicaiion cnd Permit <br />N0. ��a`o DAi'E �� �9, 1989 <br />Service Address �1� �Nt�or� _ Utility Accou�t No. <br />Billing Addras s� <br />City, State, 2ip ��tt 11� f�2C1 — <br />Owner (Mortgagor� �1ws �wc <br />Billing Name �w� <br />Con�ection By <br />DESCRIPTI ON: <br />Lot <br />Plat <br />Unplatted Descriptio <br />Type Permit: <br />Remarks: <br />/ �.• �/ « �, ,���, <br />, , <br />i: , i <br />Permit Fee jp,Op <br />Connection Charge�s) —_— <br />10.00 <br />Total Fee - <br />Signed <br />customer <br />Sewer District <br />Block -- Monthly Sewer SerVi����t� 'Sj �a� �� ;� I <br />� <br />Monthly Sewer Cor ' �`�; <br />"F'. �10.00 <br />Trunk �'� ��n'� <br />IMPORTO,NTI <br />CALl1�DOd24-5555 d8•HOURS <br />PRIOR TO DIGGING <br />CALL 2595817 FOR INSPECTION <br />SEE SKETCH ATTACHED <br />Lateral <br />Abutting Lot Line <br />N, S, E, W <br />Approved By �'� R- '!'g� <br />Ciry Erqinln <br />Issued By say H�oq�n <br />Inspection By—. �+'��� <br />Date Inspected S/�-�9 <br />NO.� Z%iZH <br />IfJ�fE�TIC i'1 <br />