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everett <br />e <br />City of Everett <br />Sewer Application and Permit <br />No. 26369 <br />Service Addreas� <br />Billing Address.� <br />DATE �GT � / � � <br />� <br />City. State, Zip(Sc���['un.ri� ♦ [i� �•-� <br />Owner (Mortgagor) � '�'�`=, �'f_.(.,L >I ", � : v_..i i;` <br />�II <br />Utility Account <br />CHART NO. <br />�'ji���� �ias�iv�� �3�88 <br />._--`�.; f �r <br />Connectian Chargels) �' �T1'lf�_ �.'�:.�i ` � �`� : ( j <br />� �.. <br />Total Fee -'-C '- <br />� �-'��,./i,(.. /(/L.�-J'�. i�.'�''itl�r'� <br />_�.� ._ . <br />Billing Name . .• �'. f � r-- — / <br />Connecti�nByl_�;�.�/�:„z.n %�./-�.�:":�;t.,_�C,c.::.:' <br />_ ;, <br />Address �'%,:! ' •rr- . - I-•, �� ii « i� Si� <br />.. r : �. <br />Phone__ �= -� -- f �,• �/ i <br />' ' `% " f �'i ! "(� <br />; i�;�r' <br />i�'/.�� . <br />: �, % .y <br />� r � <br />DESCRIPTION: Sewer District `l ^-l�--' -� <br />Lot Block �1 , Monthly Sewer Service <br />Plat -��W �_H lG�`s <br />Unplatted Description _ Monthly Sewer Constr. <br />Type Permit: <br />Remarks: <br />IMPORTANT! <br />CAIL 7SOOd24-555548•HOURS <br />PRIOR TO DIGGiNG <br />CALL 259-8811 FOR INSPECTION <br />SEE SKETCH ATTACHED <br />Trunk <br />Abutting Lot Line <br />N g E y�10l0'llD7 il=5�^pM OOOflN7�id2 �{Yt <br />/ <br />iq7002G�6S <br />5E11EF. 93f1.Q0 <br />�.f7i-�_,_�179.t1d <br />Approved By ,.,.., ��'-i.-/_'-i_'� <br />—�� ngine • <br />H01��i�4 ,i _ ) <br />Issued By 6tDfi; 5416'.5U � J <br />MEl:H 497.50 <br />G 13. <br />E <br />Inspection By �'� <br />Date I nspected ���� <br />INSPECTION <br />No. 26369 <br />