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ev�rcett <br />� <br />City of Everett <br />Sewer Application and Permit <br />No. 25692 <br />CHART NO. <br />,S'E.vT Tc c./FIa_i..c6 �/5�/87 <br />! <br />i:��+s �.x�.v�7s <br />'t1.�Al <br />DATE ���,��� I E SRf:}i giS i�i <br />Service Ada: � .�e= Sli�-#�E SM <br />Billing Address�g�.�;hFil EpE IINy-4F <br />City, State, Zip�� WR yg� � <br />�wrer (Mortgagor) kd!{ty-Ile� <br />Bi'.iing Name .___ <br />l;onnection 9v <br />PhOne_ �$}��u <br />ltUG �283.00 <br />Utility Account No. �'� �`4•� <br />� <br />Dfi�1W�' 3^cO.UU <br />Permit Fee <br />Connection Charge(s) �171-5 :152.0p <br />Total Fee �C,K 5;i05,p) <br />ae.ee <br />Spee1�1 Sewd� ClNrges (frd. 1171085 <br />Mater f152.00 <br />/';" <br />Signed � . �- � <br />customei <br />DESCRIPTION: Sewer District_ .. <br />Lot �R _ Block <br />Plat ����e� � �R Monthly Sewer Service <br />Unplatted Description Monthly Sewer Constr. <br />Perrnit: <br />Remarks: <br />IMPORTANT! <br />CALL 1-800�24-5555 48•HOURS <br />PRIOR TO DIGGING <br />CALL 259�8811 FOR INSPECTION <br />SEE SKETCH ATTACHED <br />Abutting Lot Line <br />N, S, E, W <br />Approved By <br />ciry ne <br />., <br />1.,«.., ,. <br />Inspection By, '� «�� _ <br />Date Inspected— /� -3`�� <br />IiVSP[CTION <br />No. 25692 <br />