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cH:aRT Nu. <br /> everett <br /> � <br /> City nf Everett ;'� � ,�;:;� <br /> i ,y• <br /> (." <br /> Sewer Application and Perr�nit � <br /> ,vo. 25639 DAT ' 5 1986 _ <br /> Service Add�ess 3710 - 25th /2 :�� Utility Account No. <br /> Billing Address Permit Fee Nnna <br /> City, State, Zip Connection Charge(s) <br /> Owner �Mortgagor) Total Fee Nnnc <br /> Billing Name <br /> Connection By Citv of Everett <br /> Address Signed Don Miller <br /> Customer <br /> Phone <br /> DESCRIPTIOPL• Sewer District � <br /> Lot Block <br /> Monthly Sewer Service — <br /> Plat_ <br /> Unplatted Description Monthly Sewer Constr. <br /> Re air Trunk <br /> Type Permit: P <br /> �ateral <br /> �Remarks: • ��'� � <br /> � Abutting Lot Line <br /> � ' N, S, E, W_ __ ft. <br /> o�S. S. ce w/�r/Gn U <br /> � �wleiLTk o FM. /% l±a.vn�. Fn.P i,�2 �. <br /> '�i�i7. �1- / � .1� e.c/H�f� : <br /> Approved By _ <br /> Ciry Engineer <br /> IM?(�r�F,aNT! <br /> Issued Dy SG _ <br /> CALL 1�800�4_4:�555 48-HOURS <br /> PRIOP.TO DIGGING <br /> CALL 259•8811 FOR INSPECTION <br /> Inspection By � � <br /> Date Inspected_�- %-��v <br /> v SEE SKETCH ATTACHED ' ��. Z5639 <br /> CUSTOMER COPY <br />