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everett <br />e <br />City of Even�tt <br />Sewer Application and Permit <br />CHART NO. <br />SENT Tu CNAiZTiNG <br />s•6-a� <br />N0. �vOOB DATE � � <br />�_ Utility Account No. <br />Service Address <br />Permit Fee , <br />Billing Address _ �ee <br />Connection Charge(s►��--�-- <br />City, State, Zip � � e <br />Owner (Mortgagor��� �,�� R <br />6�illing Name � <br />Connection <br />Phone <br />DESCRIPTION: <br />Lot�— BlockT— <br />Total Fee <br />Speeiai Otillty f�e Ord. 1171-85 <br />Nater 224.00 <br />S!M!� SR� <br />Signed_ c�s�ome� <br />Sewer District_ <br />Monthly Sewer Service <br />Plat Monthly Sewer Constr. <br />Unplatted�on �' UI!' ."� 12t07Fi1000Ri1:8�1 K�; <br />7ypa Permit: <br />Remarks: <br />IMPORTANT! <br />CALL 1$00�424•5555 48•HOURS <br />pRIOR TO DIGGING <br />CALL 259�8671 FOR INSPECTION <br />SEE SKETCH ATTACHED <br />Trunk � <br />80(q1748 � <br />Lateral RL�G ��1,�Q� <br />'�1711� <br />Abutting Lot Line��H ¢��'� <br />N S E W PLN Lil ilfkl.� ft. <br />i 1:.�0 <br />H S(tl�l 415.OU <br />pItUMJ S�7.QD <br />�: 3311.00 <br />qpproved BY � I1 b720.OD <br />�� <br />l;tX10U`'�8 i <br />Issued BY ���l1��— <br />Inspection By `�"�`�jD`� <br />Date I nspected G-�- f.� <br />INSP6CTION <br />N0. 26V0$ <br />