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everen <br />e� <br />City of Evarett <br />Sewer Applicatior� and Permit <br />CHART <br />r <br />� �n <br />� t, :; .. <br />��,�.. , <br />N0. Z6396 DATE 3" ��1 �'� � <br />5ervice Address 2 <br />� i 2 �,_. �.,,.,,.. ��" Utility Account No. �a � J��� 9 <br />Billing Address <br />City, State, Zip <br />Owner (Mortgagw) <br />Billing Name <br />Connection ey C i� v o r� � �e � e1" t'_ <br />Permit <br />Connection Charge(s) <br />Total <br />Signed <br />customv <br />DESCRIPTION: Sewer District <br />�a B1OCk Monthly Sewer Service <br />Pl�t <br />U�p�atted Description Monthly Sewer Canstr. <br />Permit: <br />Ramarlcs: ,?3 / <br />i <br />6 ' D =.,' .�TA.�a/ P �/e � <br />IMPORTANTI <br />CALL 1AOOd24•5555 48•HOURS <br />PRIOR TO DIGG�NG <br />CALL 259�811 FOR INSPECTION <br />SEE SKETCH ATTACHED <br />Lateral <br />GO Abutting Lot Line <br />) 9�i ' N. S. E, W <br />Approved By <br />ciry enc��eer <br />Issued BY D�'N /�'�///f 1� <br />/ Q <br />Inspection By <br />Date Inspected_ d "�8 88 <br />No. 26396 <br />Ul�ILITY GIL.LIN.; <br />