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everett <br />� <br />City ot Everett <br />CHART <br />�,.: -! �:; /'; , �.-� 1D�7�88 <br />8� <br />0 <br />.� ;. <br />.« M <br />Sewer Ap��ication cend Permit �. � , � <br />� ��� <br />No. 26840 DATE S�t�t�� 12 �.SBd ____ <br />Service Address ���u �+� !t --- Utility Account No.__ <br />Billing Address 8+r <br />Permit Fee 10.00 <br />City, State, Zip �wrt�• � �%�al <br />pwner (Mortgagor) M�n► Y�itatao <br />Billing Name <br />Connection By <br />14�fC55 <br />Connection Chzrgels) - <br />Total Fee__ 10.00 _ <br />Signed ' � ��� � �' �� � <br />c�:tomer <br />Phone <br />DESCRIPTION: Sewer District <br />Lot Block_ Monthly Sewer Service <br />Plet <br />Unp�etted Description _ Monthly Sewer Constr. <br />Permit: <br />Remarks: <br />IMPORTANTI <br />CALL 1900�424•5555 46•HOURS <br />PRIOR TO DIGGING <br />CALL 2595811 FOR INSPECT�ON <br />SEE SKETCH ATTACHED <br />Lateral <br />Abuttiny Lot Line <br />N,S,E,W. <br />Approved By u't� �' �L • <br />ciry e�Omen <br />Issued By ��t =' �_'� - <br />Inspection By ^'�� - <br />Date Inspected ���r"�` - <br />No. 26840 <br />INSPEC1lC1N <br />