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`i:., <br />�; <br /> � <br />�� <br /> CHART NO. <br /> 2veretl i <br /> �� , �'��� ;�.�.%>� �O-S-`? 8 j <br /> � <br /> i <br /> � _ <br /> City cf Everett _ . � � � � : <br /> I • � W .�r � ,J � �1 :� 1�1 <br /> I " . .. :i. .r. a� n � � �i .' <br /> oF i» .-. I <br /> �I Sewer App�licat�on and Perr�nit _ _ a � , � �.; I <br /> I i � � �i M . <br /> � �G. � � y�f -1 •�1 'J I <br /> �J �] J liJ li� '1 yT'1.� ."�,f .3 '7 (� 'J i <br /> � No. 26�31. �,_�__� � ,. _ _ `-_' -, �.. � .,. _� �� ,� ,� � : <br /> i DATE ��g�_-- I <br /> I � <br /> Service Address l,p,qi s inf,, ,�.�sT c.�,�_ Utility Account No. I <br /> BillingAddress ���'y�� �,,'tQ'Eti gr�7i32�2 PermitFee 3g,�� - I <br /> i <br /> ICity, State, Zip_,.,aa,g��r�, �,�� y�g�^ Connection Chargels) 33P:-89 � <br /> IOwner (Mortgagor) Total Fee �g�g — , <br /> Billirg Name_ Orclinance 1171-fl5 � <br /> S4ater $174.OG li <br /> i Connection By_ _ �ew�r c471.00 <br /> I v6S0.00 I <br /> Address Sig�ed <br /> Customer <br /> Phone nrea_�c�D � <br /> i <br /> DESCRIPTION: Sewer District �,� ' <br /> , Lot;l� Block Monthly Sewer Service I <br /> Plat_F,��en �ar.'. � <br /> Unplatted Description Monthly Sewer Constr. I <br /> � <br /> Trunk �-� pn _ i <br /> I Type Permit: � <br /> Lateral _ i <br /> � Remarks: Abutting Lot Line � <br /> N, S, E, W ft. i <br /> i <br /> I ' <br /> I Approved By � � <br /> iry _ngineer I <br /> I <br /> IMPORTi�NT! � <br /> Issued By �t.�=•••• * >•,-y� <br /> CALL 1-800�424-5555 48-HOURS I <br /> i PRIOR TO DIGGING , <br /> � CALL'259-8611 FOR INSPECTION � <br /> � �� I <br /> � <br /> Inspec[ion By � <br /> IIDatelnspected � � � <br /> ISEE SKETCH ATTACHED N�• �V��� I <br /> I ! I <br /> r! _ ._, . . . , <br /> I <br />