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I CHART NO._ <br /> ewre,'t <br /> � -NS .SENT To CIS�9,CTiNl. //- /2-g6 <br /> i <br /> City of Evarett � � <br /> § <br /> � o <br /> N an <br /> Sewer Application and Permit �, � � � � <br /> . � <br /> o � � � �� ; <br /> No. 259a3 DATE ile��ra4. ;9Rf <br /> Service Address �a3n ct t w.,- � :,�-.. a y Utility Account No. <br /> BillingAddress_ ��_ Permit Fee 70 00 _ <br /> City,State, Zip_�R� �� 95�0' Conr ion Chargels)_ »0 00 <br /> Owner (Mortgagor) ni,,,,r i �e,n„m Total Fee_ <br /> �A Of1 <br /> Billing Name 8+� __ �'u�� �.1171-BS: �471.00 <br /> Connection By <br /> Addr_ss Signed <br /> cusromer <br /> Phone- J77-i174 <br /> DESCRIPTION: SewerDistrict N��.� ,v: <br /> Lot Block <br /> Plat Monthly Sewer Service <br /> Unplatted Uescription Monthly Sewer Constr. <br /> T Permit: — Trunk <br /> YPB New Gorcwctiwi <br /> Lateral <br /> Remarks: Fa;d L �1L 71> Mrc*ement, b;�i? qbutting Lot Line <br /> inmice fur siQTM se»er ccnstruetior. sinrx_�u b N, S, E, W ft. <br /> le al � TL orn�cr ';efore lUil/L'r l'u: <br /> Gclia Strc:nn <br /> 3"UU Cera•• �t 11LFPtG N, TFa{�!L <br /> Approved By <br /> Evcir.tt� WA a8?Ol arvE�c���n <br /> IMPORTANTI f�ary:,ret E. �icLeo:; <br /> Issued 8y <br /> GALL 1500-024�Ei55548-HOURS <br /> PRIOR TO DIGGING <br /> CALL 259�8811 FOR INSFECTION �/ <br /> Inspection B��� <br /> / <br /> Date Inspected � �-7 '�� �-•a <br /> SEE SKETCH ATTACHED No. 25903 <br /> Ih�SPE-CTION <br />