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everen <br />e <br />City of Everett <br />Sewer Application and Permit <br />N0. �vo�� DATE aaeu..+ 2]. 1s87 <br />Service Address �20 rrlaes� <br />Billing Address 920 Il�tao� <br />CHART NO. <br />Utility Account No. <br />$%JTT� C:4/l.t?'/JG <br />�`!/87 <br />$S <br />co <br />.. -. <br />.,, � <br />�� <br />�-.�jjjJJJ((( 1 <br />N !w� U <br />\ '� �j� <br />0 <br />Permit Fee 10.00 <br />City, State, Zip— =wr�tt. ►G 9l201 Connection Charge(s) <br />12�32 Gib�on Rd <br />Owner (Mortgagor► Tr�at LAov �.�.�* w g82Qatal Fee 10.00 <br />Billing Name M� Nil�oe <br />Connection <br />DESCRIPTION: <br />Lot Block <br />� - <br />Signed ' ' � � <br />( : Cu:Iomer <br />Sewer <br />Plat Monthly Sewer Service <br />Unplatted Description Monthly Sewer Constr. <br />Permit: <br />Remarks: <br />IMPORTANT! <br />CALL 1300�424•5555 48-HOURS <br />PRIOR TO DIGGING <br />CALL 259�8811 FOR INSPECTION <br />SEE SKETCH ATTACHED <br />Tru <br />Abutting Lot Line <br />N, S, E, W. <br />Approved By aTdRED R. TItRJ1L <br />Ciry EnOinen <br />Issued By ►'Yn7ab�t S. MeLod <br />` Inspection Bx � �'`� <br />Date Inspected_ /-076 -� <br />INSPECTION <br />No. 26038 <br />