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c <br /> t <br /> I <br /> y . <br />�'' <br /> �,w � <br />�� � ' <br />' � <br /> CHART NO._ <br /> � <br /> �.vere ��a� �-c c r�-A�N�. <br /> � 11�z��y <br /> City of Everett <br /> Sewer Application anc� Permit <br /> N0. L�V�� DATE January 13, 79[tn <br /> Service Address �p,�.5t� ---. Utility Account No. <br /> BillingAddress �_ PermitFee zn_nn _ <br /> City, State, Zip Connection Charge(s)��oe <br /> Owner (Mortgagor) ' Total Fee �o_nn <br /> Billing Name Dtility Developnent Fee OR��. 1172-35 <br /> wetxs 179.00 <br /> Connection Ey sawer 47I.00 <br /> •� 650.00 <br /> Address Signed —`'" � I <br /> �Customer <br /> Phone.�s,.,�_ I <br /> DESCRIPTION: Sewer District � • � <br /> I <br /> I �; :.�,', , ....: � ' , .� � ,.,. . :-'r:a � <br /> Lot � Block MonthlySewerServ���-`� ya ! <br /> Plat -_���l�ff i <br /> •a�l,ii[F. �.;O.C1U <br /> ; Unplatted Description Monthly Sewer Const�,. ,� ,�� �.� <br /> Trunk ;i�tC'�tpjL,173 i <br /> Typ8 Permit: �W �,��etion w' `�.. :"� •�° <br /> Lateral ��UUD21�ili � <br /> , �• �<. ; — I <br /> Remarks: 1'Lf?{, �;,��p <br /> Abutting Lot Line;�fi,�� „ol,�,� � <br /> N S E W >�;,�; , .�_,��. ., ft. <br /> f: ::A:�H r3.`ill <br /> t. ifrCH Y 7�.lNf <br /> IiR!'!1V �0.!� <br /> tlfciti Sl.ti!)4,s.3; <br /> APProved By 7�.F'Itge �^ '�ii�•A� <br /> Ciry Engmeer <br /> iMPORTANT! <br /> Issued By >ys [iatu�ea <br /> CALL1•800•424-555546•HOURS 3 J � <br /> PRIOR TO DIGGING � <br /> , <br /> CALL 259�881�1 FOR INSPECTION <br /> Insper.tion By �/— I <br /> Date Inspected f-�"�% <br /> SEE SKETCH ATTACHED No. 27�4i <br /> ��,.i��n�_;;;IOid <br /> I <br /> I <br /> I <br />