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everett <br />e <br />City of E� are <br />Sewer <br />� <br />� <br />tt � �;$pr�:s38 $ 88 ; <br />N ei d�iT�� Ma�r � �ry� <br />Appdicc��a� an�e� � " <br />m ����� ��' ����� <br />No. 25759 � DATE _� Julv 18� �� ~� <br />(S61S) <br />Service Address_�1.5 Seued Ar�_ <br />Billing Aadress_ 315 NE 192nd <br />City, State, Zip Seittle YA 9B1 S5 <br />Owner (Mortgagor) Deeald A_ Sstth <br />Billing Name Se�e <br />Connection By <br />Addrr_s <br />Phone t6�teaa e� R��s�gn <br />CHART N0._ _ <br />s,�_�� <br />sE.�„— re �,�.v�r,,�.� <br />/-?.G-d 9 <br />Utility Account No. _ <br />Permit Fee __ 3ff_n�t <br />Connection Chargels) �*�* sw.� $� l 11it_�j <br />Total Fee �e nn <br />Special Fees OM, 1171-R5 <br />wac� - zxa.00 <br />Signed <br />cuswmer <br />DESCRIPTION: Sewer Disirict t�...� t� <br />Lot 6 _ Block <br />Plat _ K�nilrarth Nill s N0. 1 Monthly Sewer Service <br />Unplatted Description Monthly Sewer Constr. <br />Type Permit: <br />Remarks: <br />IMPORTANTI <br />CALL 1AOOd24•55F548•HOURS <br />PRIOR TO DIGGING <br />CALL259�8811 FOR INSPECTION <br />SEE SKETCH ATTACHED <br />Abutting Lot Line <br />N, S, E, W <br />Approved By ��s� <br />Ciry�npineer <br />Issued By e bjrol�n <br />Inspection By ��"" "� _ <br />Date Inspected i �i- d"' <br />Ii�SPECTION <br />No. 25759 <br />