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evereri <br />e <br />City c'. Everett <br />�� <br />� ����� <br />'i -' �� o a� ri <br />�7 i � Nr <br />Sewer Appiicatian and Pei��it _ _ ` <br />� R � V � � � � <br />y� ��'����::. <br />No. 27730 DA7E _� 9 �non <br />� g 3L Utility Account <br />Service AddrE�ss 1� g��� a� <br />Billing Address 1so2e anc�+ �.. ++�+ <br />City, State, Zip A�����• vx o�g? <br />Owner (Mortgagor) SCTIilNch ooest. _ <br />Billing Name <br />Connection By <br />CHART <br />�v �DLjc��N�� <br />,� _ , _9, <br />Permit Fee 38.,g� — � <br />Connection Charge�s) __ <br />Total Fee '+�-�A— <br />Osdiaanca 1171-85 <br />wter 179.00 <br />taver •71.00 <br />650.00 <br />i � �. <br />Sign�d ' T—= <br />Customer <br />Phone <br />DESCRIPTION: Sewer District — <br />Lot Block Monthly Sewer Ser�ice <br />Plat <br />Unplatted Description Monthly Sewer Constr. <br />Permit: <br />Remarks: <br />IMPORTANTI <br />CALL 7�800d24-5555 48•HOURS <br />PRIOR TO DIGGING <br />CALL 259-BB11iFOR INSPECTION <br />SEE SKETCH ATTACHED <br />Abutting Lot Line <br />N, S, E, W <br />Approved By � �0� <br />Ciry Engineer <br />Issued By J Rocicv�ll <br />(' <br />Inspection �y - l�� <br />Date I nspected lG �- � <br />No. 27730 <br />Ili` ; ��i'�i I;�?;�! <br />