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everett <br />,,e. <br />City of Everett <br />Sewer Application and Permit <br />No. 24001 <br />Service Address <br />Billing Address. <br />City, State, Zip <br />Owner (Mortga <br />Billing Name_ <br />Connection Bt <br />Address— <br />Phone — <br />DESCRIPTION: <br />Lot <br />Plat <br />Unplatted Descri <br />Tvne Permit <br />DATE <br />5/27/81 <br />9602 19th Avenue S.E. <br />RSRSXTxxx{XSX Sane <br />Everett, Wa. 98204 <br />Oscar Ponce <br />Sane <br />W. r. Brenner <br />337-9090 <br />Block <br />to 18 28 5 <br />New Connection <br />SEE SKETCH ATTACHED <br />CHARTNO.Z18-28-f- <br />Utility Account No. <br />14916-1 <br />Permit Fee 160.00 <br />3,268.46 <br />Connection Charge(s)_ <br />160.00 <br />Total Fee_ <br />Ordinance #714-00 <br />Area 2 <br />Signed <br />Customer <br />14,186.02 <br />33 Bond 'III <br />Sewer District_ <br />Monthly Sewer Service Metered <br />Monthly Sewer Constr. <br />Trunk 10.14 1.187.20 <br />12.51 1-101.26 <br />Lateral <br />Abutting Lot Line <br />N, S, E, W 338 <br />Approved By A. R. Thea1 <br />City En3ineer <br />E. Bond <br />Issued <br />Inspection By ' <br />Date Inspected ( V t- j <br />No. 24001 <br />INSPECTION PCSTGb <br />