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evereK <br />e <br />City of Everett <br />Sewer Application and Permit <br />No. 25555 DATE <br />��j � ��_�X' ' Utility Account No. <br />Service Address___�_�'_�_-�� — <br />,;- ���� a•� <br />l. �` � f -.. ?, � c ' � � Perm;t Fee <br />Billing Address - <br />, <br />_; � <br />r�. ;'1 ';7;, <br />City, State, Zip �-% - <br />Owner (Mortgagor) • � <br />.i <br />Billing Name ' ' �--' <br />Connection <br />Connection Chargels) � <br />Total Fee <br />��� B d <br />. ._ . `-: — <br />J <br />Signed -- " <br />Cus[omer <br />Phone ' -/ -- � - „ /� i., <br />DESCRIP�ION: Sewer District <br />Lot ��o �� Monthly Sewer Service <br />� <br />Plat ' <br />Unplatted Description Monthly Sewer Constr. <br />Type Permit: <br />Remarks: <br />IMPORTANTI <br />CALL 1-800�424•5555 48-HOURS <br />PRIOR TO DIGGING <br />CALL 259�6811 FOR INSPECTION <br />SEE SKETCH ATTACHED <br />Abutting Lot Line <br />N, S, E, W <br />Approved By � - � •` l <br />City Enpineer <br />Issued By ' ' , <br />Inspection By � <br />Date Inspected '3-� �� <br />Ii�1SPGCTiON <br />NO. 2`�`�`�'lrJ <br />