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everett <br />� <br />Ciry of Everett <br />Sewer Application and Perrv�it <br />NO. G4999 DA'rE �6°uary 7, 1985 <br />7107 �y �.,re <br />CHART NO. � f' °-��� — <br />,'i'ir/�f'y—� I <br />✓'/ I <br />e /) � e� <br />Service Add'ess ._ --- Utility Account No. <br />Nonrt <br />Billir�g Address _— Permit Fee _ — — <br />City, State, Zip_ __ Connection Chargels) <br />Owner (Mortgagor)_____ <br />Total Fer. �e <br />Billing Name____--- — <br />Cannection By_City of_tswrett _ <br />; igne� D°n ►till�r <br />Addf855___ ----- Customer <br />DESCR PTION: <br />Lot Block____ __ <br />Plat-- --- <br />Unplatted Description_.__-- <br />Type Permit: =epsir ___ <br />Remarks: ����y�� f��,1_� � � <br />��•ii✓�a�.*ytr.�'" ��-, 1t <br />�z,c .rn`4 , x.� R'> � 3 <br />Sewer District <br />Monthly Sewer Service <br />_ __ PQonthly Sewer Constr. <br />-- l'runk <br />_ J Lateral__ <br />Abutting Lot Line <br />/m. /r • N S, E. W— <br />T: � — <br />SEE SKETChI ATTACHEO <br />INS�'LCT'.ON <br />i <br />Approved BV n. F. Thesl I <br />Ciry cng'^eer <br />I�sued Bv F. H°nd __ I <br />�j.�iii'l �'R_ ��Y. ��'!� C/�' <br />Inspection By � <br />Date I nspecteo_ � " � ( `� � -- <br />N�. 24999 <br />