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everen <br />e := <br />� <br />City of Everett � � � � �; g � � �: ` :r <br />-9 t��- Y c i a i� ±''. -i <br />�•� �-a M �. CL � ' 1 <br />iw . . -. <br />Sewer Application �nd�ee�r�lit ��� <br />; , <br />:>r �����-������_'--- <br />27457 �. ��-wLL� ��4._.�'_:� <br />N0. DA�`I"E ��asti+ �T, 1siLa <br />Service Address <br />Billing Address <br />City, State, Zip <br />Owner (Mortgagor) , <br />Billing Name <br />Connection <br />Phone <br />DESCRIPTION: <br />Lot <br />Plat <br />Unplatted Descri <br />Type Permit: <br />Remarks: <br />Block <br />IMPORTANT! <br />CALL 1-800-024-5555 48•HOURS <br />PRIOR TO DIGGING <br />CALL 259�8811 FOR INSPECTION <br />SEE SKETCH AT'fACHED <br />'r0 �5T'iNy <br />Utility Account No. <br />Permit Fee_ _ __ 30 00 <br />Connection Charge(s) ��_6S0 a9 <br />Total Fee �0 00 <br />Water 261.00 <br />EQrer 680.00 <br />949.00 <br />/ „ ,( <br />Signed --- <br />Cu:tomer <br />Sewer District no..w T <br />Monthly Sewer Service <br />Monthly Sewer Constr. <br />Trunk � e. <br />Lateral �, ce <br />Abutting Lot Line <br />N, S, E, W <br />Approved By �'�D R. THLAL <br />Ciry Engineer <br />Issued By s�Y Etauqen <br />Inspection <br />Date I <br />IfJSPGC i ICf�' <br />�'-/7-su <br />No. 27457 <br />