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everett <br />e <br />City of Everett <br />Sewer Application and Permit <br />No. 23675 <br />�iz5ieo <br />DATE <br />Service Address Sa;l 27th Avenu• Neat <br />Billing Address 5101 27th l�venne Meit <br />City, State, Zip B�er�tt, Yta. 98203 <br />Owner (Mortgagor) Mike A. Loaq <br />Billing Name Mik• A. Long <br />Mika a. Long <br />Connection Bv— <br />Address <br />355-3773 <br />Phone <br />DESCRIPTIOh: <br />Lot 8 Block � <br />Plat Saaviev 8elqhts <br />Unplatted Description <br />CHART NO.-W 35-Z9-'-� <br />�s,-E� 3-2s-81 <br />� <br />Utility Account No. �5980-3 <br />Permit Fee 30.00 <br />Connection Charge�s) 655.50 <br />30.00 <br />Total Fee <br />Signed <br />Customer <br />SEE SKETCH ATTACHED <br />INSP[CTION <br />Sewer District �� Bond 2 <br />Monthly Sewer Service 3. BO <br />Monthly Sewer Constr. <br />Trunk 1.15-255.00 ;=YYkll <br />Lateral Z•Z5-i22.50 6=jgs� <br />Abutting Lo! Line <br />N, S, E, W. <br />_ft. <br />Approved By �• wnrren <br />Ciry Engineer i <br />E. Bond <br />Issued By <br />. <br />� <br />a <br />J �� i <br />Inspection B <br />Date Inspected a y k'�f� <br />N�. 23s7� <br />9 <br />