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everett CHART NO. _ <br /> � . ' M1928S <br /> City of Everett <br /> Sewer Application and Permit <br /> No. 255$5 DATE � 1� 1 t__19R6 <br /> �08�2 <br /> Service Address�� 6�h ��e 3E Utility Account No. <br /> BillingAddress 1b21 - 113th !k SE Permit Fee 'A�Ag <br /> City, State, Zip crK�tt YA�82C5 Connection Chargels)_ 330 � <br /> Owner (Mortgago�) Total Fee 30.D0 <br /> eilling Name SpetSal Sever Fees OM 1171-85 <br /> Mate� 152.00 <br /> � Connection By _ Se�P 4��� <br /> � <br /> Address Signed <br /> Customer <br /> Phone 3J4-852A <br /> DESCRIPTION: Sewer District tj= <br /> Lot 16 Block _ <br /> Plat Monthly Sewer Service <br /> a.ss cr..t �x _— <br /> Unplatted Description Monthly Sewer Constr. <br /> Type Permit: <br /> — Trunk_��n� <br /> Lateral <br /> Remarks: <br /> Abutting Lot Line <br /> __ N, S, E, W ft. <br /> Approved By <br /> c�c u� <br /> IMPORTANTI <br /> CALL 1�00�424-555548-HOURS Issued By_3. �PdMNtI <br /> PRIOR TO DIGGING <br /> CALL 259�8811 FOR INSPECTION <br /> InspectionBy ` /�-����— <br /> Date Inspected �I ( � � <br /> SEE SKETCH ATTACHED No. 255�5 <br /> INSPC:CTION <br />