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f +A �(' <br />C�'I•�"C�ill <br />� <br />City of Everett <br />Sewer Application c�nd Permit <br />��' NO. 2��g� DATE _ <br />�� Service Address � � g -�� �� <br />�. <br />,:,. . <br />Billing Address <br />';i% <br />�:. <br />^ City, State, Zip <br />�' <br />�-�' Owner (Mortgagor) <br />'"i Billing Name <br />,; <br />" Connection By <br />.� ; , <br />Address <br />,: Phene <br />:,�� DESCRIPTION: <br />,., <br />Lot Block <br />Plat _ <br />, Unplatted Description <br />Type Permit: '4 �y,�� <br />Rernarks: <br />., � c,�-o,� a <br />-�-__ i ...-% <br />—� � . <br />IMPORTANT! <br />cA�� i-n^uC-�!21.565� 48-HOURS <br />PRIOfi TO DIGGINC <br />CALL 259-8811 FOR INSPECTION <br />SEE SKETCH ATTACHED <br />CHART NO. i I :— ' -: -•=-`' <br />, <br />, 1 ` , I � <br />I <br />_-� i <br />t,.. � <br />Utility Account No. <br />Permit Fee <br />Connection Charge( <br />Total Fee <br />,�la T.mms 1��Q• <br />�,/89 <br />Signed i <br />Customer <br />� <br />Sewer Oistrict <br />Monthly Sewer Service. <br />Monthly Sewer Constr. <br />Lateral <br />Abutting Lot Line <br />N, S, E, W. <br />Approved By <br />City EnBineer <br />I ssued <br />Inspection By ti,f?�-������� <br />Date I nspected � — / �' � 7 <br />�''. � �'`i _� <br />N 0. , �_ <br />CU�TOi`<iG,"� CO!' ;, <br />