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i � <br /> � I� <br /> CHART NO._ _ <br /> everett <br /> -1== �d s t'l�.o� I <br /> � 3--2<i -� <br /> City of Everett <br /> � <br /> S�wer �4pplica�ion and Perrroit <br /> � <br /> No. 2�93� DATE ttove.mber 0, 19ot� _ <br /> � <br /> Service Address_ �ggz,rYkg���� Utility Account No. <br /> I <br /> ( Billing Address PaO. �+�v sc2 Permit Fee . <br /> City, State, Zip .�xW�;yi.,8r.p.A gpy�3� ConnectionCharge�s) <br /> —33Gr i•.) <br /> Owner (Mortgagor) r�Ai� y �+� Total Fee_���_._.____ <br /> Utility D�vr.lop:uent Fec�C�::.d 1171–F,5 � <br /> Billiny Name S,•m•• water 179_OC� I <br /> sPwer 4T.1.00 � <br /> Connection By ��a 650.00 <br /> Address_�_�,� _ Signed <br /> Cu�.:tomer <br /> Phone �,g3..,�g�g <br /> DESCRIPTIOPJ: Sewer District ��� <br /> Lot 16 Block <br /> Monthly Sewer Service <br /> Plat r.a�a�� nar • t_.�0`iJ�#: ,.�--,I"�� ! : � . <br /> <_..j.. ' Ip.i111t� : 'iii_^ . <br /> Unplatted Description Monthly Sewer Constr. ' <br /> i�U:iu°]7�,n <br /> Trunk f;i(d; -'r;:,i;p <br /> Type Permit: n+eu �nnection i9l�,,.jA1 <br /> Lateral h�.�_;; !:tt,50 <br /> [: 3f?I:tl t3.50 <br /> Remarks: i' �;C'f;H ;15.!ri <br /> Abutting Lot Line � <br /> — N' S' E' Wl���V'6,��n �:__ t:0.i1U fL i <br /> !'f,Tf.F: �:,U.Of ' <br /> iiUui i;'!.•9)ii �, <br /> !�I,i_f' :'.�j,iiG � <br /> l;�i'"i! � ::3it.t!�; '� <br /> Approved By�t,� � : �; <br /> � I <br /> i lif�'S; :��i:i��i,.GO <br /> IMPORTANT! <br /> Issued By <br /> CALL 1-800�424-5555 48-HOURS ' <br /> PRIOR TO DIGGING i <br /> ' CALL 259-8811 FOR INSPECTION � - ;: � <br /> Inspection By , � ' <br /> __ Date Inspected� �� I <br /> CS I <br /> SEE SKETCH ATTACHED N0. ��J�� <br /> ;�!`' ..:'iIOF' I <br /> I <br />