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a <br />everett <br />e <br />City of Everett <br />Sewer Application and Permit <br />CHARTNo. f- 3 G " 2 7 --� <br />No. 26398 DATE 26 L <br />Service Address 5 3 2 "A �� Utility Account N <br />Billing <br />City, State, <br />Owner (Mortgagor) <br />Billing Name <br />Connection ByL� <br />Address— <br />DESCRIPTION: <br />Lot <br />Plat <br />Unplatted Descripti <br />Block <br />Tvoe Permit: i-ho rn r, i a <br />eo 1E� 111-6 <br />�I <br />xo <br />Permit Fee_ _ <br />Connection Charge(s) <br />Total Fee <br />Signed... <br />Custon <br />Sewer District <br />Monthly Sewer Service. <br />Monthly Sewer Constr. <br />Remarks: <br />- <br />M <br />na�. <br />A /6 <br />IMPORTANT! <br />CALL 1-800-424.5555 48-HOURS <br />PRIOR TO DIGGING <br />CALL 259-8811 FOR INSPECTION <br />SEE SKETCH ATTACHED <br />Lateral. --- <br />Abutting Lot Line <br />N,S,E,W, <br />Approved By <br />City Engineer <br />Issued By �! 1li rJ M l �4 I <br />Inspection By 7 C)d� <br />Date I nspecte �� <br />No. 26398 <br />UTILITY BILLING <br />