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everetl <br />e <br />City of Everett <br />Sewer Application and Permit <br />CHART NO. — <br />J�' ��� ,� C�ianY'N�y <br />/-S -9/ � <br />N0. LV�QJ DATE � <br />Service Address �»� o A* — Utility Account No. <br />Billing Address_15fi01 ' *� SE — <br />City, State, Zip u�» r � NA 9B^'� <br />Uwner (Mortgagor)_.�.,r�_+ toi <br />Billing Name <br />Connection By ��.._Lt l3�a - <br />Address .,�-���7 Lpan�iond - <br />Phone <br />Permit Fee <br />Connection Charge�s) <br />Total Fee <br />Utillty D�valoprrt�t i�e Ord. 1171^85 <br />qiar 224.00 <br />sw�r 584.Off <br />81].00 � <br />Signed " � <br />Customcr <br />DESCRIPTION: Sewer District <br />uU � � }�::�,�+ rx�ari�trrs r�:t:; <br />Lot �o Block Monthly Sewer Service ' <br />Plat * � o«g� - iiUl�t]'i973 <br />Unplatted Description Monthly Sewer ConqYTl'f: sd0.0U <br />Sil1A:267t79 <br />Trunk '.�I �F• :i �It1 <br />Type Permit: CRA? it t.:. L�.00 <br />Lateral 11;1-5 stli3.Ui1 <br />il00(]�."'(IhOQ <br />Remarks: Abutting Lot Line���-�� '^'�"�'� <br />N S E W I,LI>Yi ��7Q.00 ft. <br />r _ , ff... <br />I'1.11 i:ll +�14.03 <br />F: !ii�S:H b3..`A <br />E i�tiJl S15.t!6 <br />APProved By D1�4nJV :�O.i10 <br />�q��, - <br />IMPORTANT! <br />CALL 1800-024-5555 48-HOURS <br />PRIOR TO DIGGING <br />CALL 259-8811 FOR INSPECTION <br />SEE SKETCH ATTACHED <br />Issued By <br />Inspection B <br />�atelnspected <br />� rf <br />INSPGCTICN <br />No. 2b7�i3 <br />