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W <br />City of Everett <br />Sewer Application and Permit <br />No. 25968 DATE <br />October Y, 1996 <br />Service Address trttt — 112Vd et Utility Account No <br />Billing Address e_n_ Umt s1&7 <br />City, State, Zip—tW-&zS t. oesnc <br />Owner (Mortgagor) — <br />Billing Name ai� <br />Connection BV :... <br />Phone <br />DESCRIPTION: <br />Lot t+—;A Block i7_ <br />Plat of I1.Wtt <br />Unplatted Description <br />Type Permit: <br />Remarks: <br />IMPORTANT! <br />CALL 1-800424-5555 48-HOURS <br />PRIOR TO DIGGING <br />CALL 259$811 FOR INSPECTION <br />SEE SKETCH ATTACHED <br />Permit Fee. <br />ConnectionTotal Fee_ <br />Signed <br />Cnstom ' <br />Sewer District <br />Monthly Sewer Service <br />Monthly Sewer Constr. <br />Trunk <br />Lateral <br />Abutting Lot Line <br />N, S, E, W. <br />Approved By ALreen e_ rwr&c <br />City Engineer <br />7- <br />Inspection. By C- .r n� e^ <br />Date Inspected "/6 <br />No. 25868 <br />INSPECTION <br />