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everen <br />e <br />City of Everett <br />Sewer Application and Per�it <br />No. 25401 DATE ��' <br />Service Address ��� �� �t a•�• <br />CHART <br />s�.�,-7� C'S'9�7'.,�� �-z9-$c <br />y�sc sE...r�c�E�.�c <br />�o a�E .PErv-c:UFp. <br />Utility Account No. <br />Billing Address � i�zi s_z_ a�ar.et u r.� permit Fee 30_00 <br />Snita 1 <br />CitY. State, Zip �• �• 98201 <br />Owner (Mortgagor) �r k��Y <br />Billing Name <br />Connection By <br />Phone 3�e—]63S <br />Connection Chargel <br />Total Fee 30.00 _ <br />Signed - <br />cu:tomer <br />DESCRIPTION: Sewer District e°°d II <br />Lot � Block <br />Plat r..iiweth ltl1L il Monthly Sewer Service _ <br />Unplatted Description Monthly Sewer Constr. <br />Type Permit: <br />Remarks: <br />IMPORTANT! <br />CALL 1-800�124•5555 46-HOURS <br />PRIOR TO DIGGING <br />CALL259�8811 FOR INSPECTION <br />SEE SKETCH ATTACHEfl <br />Lateral <br />Abutting Lot Line <br />N, S, E, W <br />Approved By�_ p_ �.a1 <br />City En9ineer <br />Issued By s• n°� <br />Inspection By � ""`4e%"'a"'` _ <br />Date I nspected ��G '� <br />No. 25A01 <br />INSPECiION <br />, <br />