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CHART N0. <br /> I everett 'I <br /> ��� � , <br /> 9H i <br /> ay� i City of Everett <br /> rx� <br /> r <br /> ` y� i Sewer Application and Permit <br /> " �H i <br /> t� y� I N0. � r Oj.t DATE 1� — I <br /> OH � I <br /> Service Address Utilit A � <br /> c~i:�� ��2� �3�d �v�, ti_ y ccountNo. <br /> y y Billing Address._�.�P�._ £� � Permit Fee i <br /> r H y - .. . I <br /> ty tn I City, State, Zip tlnh�Eao, Wa� 43�75 Connection Charge(s) <br /> o C� � <br /> � �� I Owner (Mortgagor)_ttn�eh H}clra, Total Fee�� i <br /> tj] <br /> y p y I Bi'ling Name_ �� Utility Levelornent Foa Oid. 1171—I35 I <br /> � wat'er 229.00 � <br /> � Connection By___ �� __ _ ! <br /> r/i � <br /> ' Address� - — Signed 6' �i � ' � I <br /> 1 -_. i <br /> i —� Customer � <br /> � Phone --�6Y—d93 --- � I <br /> �� I <br /> � I i DESCRIPTION: ��' I <br /> r.� Sewer District�_ _ i <br /> Lot �z Block I <br /> i Monthly Sewer Service_ <br /> � �., Plat --��#�wertm �5 � <br /> ! �..! I Unplatted Descriplim Monthly Sewer Constr. i <br /> (""�� Type Permit: Trunk `, . ,„l . <br /> '��-4Irf1 H I41�i ` <br /> ����� � M <br /> Lateral ' <br /> — -- ,�,,. -.--"t.xr,�"s�i:;-- <br /> f ,�, Remarks: 4a��(92 ',-;�l.i.�l I <br /> „e�� Abutting Lot Line�;i,iu;:l"'lb <br /> � -- N, S, E, Wnira i�,�a �;tt ft. <br /> � f9..1?i .^.�i:i.IMJ <br /> ����;{ ?..yi.:�l� <br /> ^'^ ^+ f'; I I CH :14A7.`I�` � <br /> t: i;k:C(I S'.'.�li <br /> f..► Approved By i ,��r�H tiS.i;L� <br /> I„� � �� .. � <br /> � IMPORTANT! t+iitt_',�i��i i � <br /> Issued By �t.lti,6� i-;(1,Ii0 <br /> CALL 1�80D�424-5555 48�HDURS <br /> � I PRIOR TO DIGGING i� �� -' -•-s.(YI I <br /> �,11EC7; et.'-.li';.',':i � <br /> iI C's� f <br /> CALL 259-8811 FOR INSPECTION � <br /> ' Inspec[ion By� � <br /> I <br /> — Darelnspected -�� �f I <br /> I SEE SKETCH ATTACHED N0. 27�12 I <br /> I <br /> � I rJ�i'[r;i�o'�; I <br /> i ; <br /> ; <br />