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everett <br />e <br />City nf Everott <br />�ewer Application and Pe�mit <br />CHART N0. <br />_" � �1.�'C� T `� �_'•='.� i �',r�,'a.. <br />; �� . �� �;.'� <br />N0. � 1 y03 DATE M+zch e. 1989 �, <br />� (DaiC <br />5ervice Address Utility Account No. <br />Billing Address . Permit Fee 30.00 <br />City, State, 2ip <br />Owner (Mortgagor) <br />Connection Charge�s) 720.00 <br />Total Fee 30.00 <br />Billing Name ntility O�lop�en! !w Ord. 1171—BS <br />wt�r 179.00 <br />Connection By _ aw�r �71,00 <br />; �-� •650.0�. <br />; <br />Address__�r _ Signed_ '�� : �Kr*��a'rf� y.om tyi:' <br />cmtomer f <br />Phone �k1pp���7} p3 <br />:fI�R 8��.00 <br />DESCRIPTION: Sewer District._eond�fl�tLr��ry� pp <br />Lot Block 1171 :i �fi50•f�1 <br />Plat Monthly Sewer Servj��q,c�� <br />H{1Tkli 4�+SO.OQ <br />Unplatted Description Monthly Sewer Con�i y�tf;,� <br />Trunk L�-�3 � 445.i.fS <br />Typa Permit: �-� itld'� <br />wr °°`n�atim i ECiI 9.33.00 <br />Later�l ����_�3 � <br />Remarks: [ 5Ftif1 i15.W <br />Abutting Lat Line GRI,Ff1 Z20.(Fl <br />_ N, S, E, W CF�:C1: s26?`.75 ft. <br />IMPORTANT! <br />CALL 1500�424•5555 A8•HOURS <br />PRIOR TO DIGGING <br />CALL 259�8QTTfOR INSPECTION <br />SEE SKETCH ATTACHED <br />Approved By- u�IIae u- r�eaL <br />Ciry EnOinea <br />Issued By sn.y.��.n <br />� <br />Inspection B�� ��� <br />Date l nspected �v - � ' � <br />IidS?CCTIOPJ <br />No. 27103 <br />