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everett <br />e <br />City of Everett <br />Sev�er Application cnd Permit <br />NO. Z%OZO DATE � <br />Service Address ��� Y� IIt• <br />Billing Address � 10122 7th 1►�. <br />City, State, Zip �=�tt, Ti11 98208 <br />Owner (Mortgagor) �� �� <br />Billing Name <br />Connection By <br />Utility Account No. <br />Permit Fee �o � <br />Connection Charge(s) �ze_oe <br />Total Fee ]o 00 <br />Utility <br />D�wlop»at b Fa� azd. 1171-85 <br />val�r 224.00 <br />swer �71.00 <br />ilW�. 811.00 <br />Address Signed ' � <br />cu�tomer <br />Phone U1i05/135• °:�k]AM I1011�Ufz9o� �'iik <br />DESCRIPTION: Sewer District d.� *** <br />NtNhl�l�7.0 <br />Lot�.O Block MonthlySewerServfFVER �'��.[M} <br />Plat *�a�-;-• — I%kQi1I ?:�'A.00 <br />Unplatted Description Monthly Sewer Con4d'i 1=: ib13.[�? <br />tW�)o154 <br />Trunk Fk�l •EU.(n] <br />Type Permit: � ��ti� !ffr�!)�i311 <br />Remarks: <br />IMPORTANT! <br />CALL 1-600-424•5555 48•HOUflS <br />PRIOR TO DIGGING <br />CALL 259�8811 FOR INSPECTION <br />SEE SKETCH ATTACHED <br />Lateral Lfl.UI; 854`t•,�t1 <br />f'l.l� 4h5.00 <br />Abutting Lot Line���-�{ f`�.''� <br />N S E W f; SiRCH ��?,•� ft. <br />'L :Ii; t �. <br />lil'"JW'; :<:l.tti] <br />CNf!'1� 31?Ik.�iO <br />Approved By <br />City nginem <br />Issued By <br />Inspection By��E'��2e° [��=�--� <br />/ <br />Date Inspected 3///Q/� <br />INS°[CTION <br />N0. 27�2� <br />