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i ' <br /> i <br /> � �� <br /> , <br /> ?i <br /> � � <br /> ! 's <br /> CHART f�0. � <br /> everett <br /> s�r.l-�- �-p �S'C"I�D <br /> e � . zs. eR <br /> City of Everett <br /> Sewer Application and Permit <br /> N0. ��O�O UATE Ja�uary 12. 19II9 <br /> Service Address 4715 St� 7►�ve W Utility Account No. <br /> 9illing Address �q,+��;����,��},—#���� Permit Fee 30.q0_ <br /> City, State, Zip���.. ;R gyd�� Connection Chargels) �e <br /> Owner (Mortgagor��_,.�g�,e.{��o�� �e��ee Total �ee 30.00 <br /> Billing Name �_.__ Z tltility eevelopnent Fee ord.117�-85 <br /> wat4r 179.00 <br /> sewer d71.00 <br /> Connection By �- 650.00 <br /> � , <br /> Address g--- Signed ' '-----� -- <br /> Cuslomcr <br /> Phone 393 93�5 <br /> Uli;S�'f'.;' ..:52F'h flilt4:t:�i2i^ i"r:i:r <br /> DESCRIPTION: Sewer District <br /> Lot a Block �i��i�j�'Iifti1) <br /> Plat Monthly Sewer Serv��e� _ ; ^ <br /> -f..€ , .. <br /> 11'r!-5 'GSO.IhI <br /> Unplatted Description Monthly Sewer Constr <br /> ;.upG21414 <br /> Trunk ld_L�i fi�i37.[�! <br /> Type Permit: p�r �njlection �' �'''• ` <br /> Lateral <br /> r�7:Cl! !r,'I.:�fi <br /> _ _.. . ,�' <br /> Remarks: F 5f.•f.�N �i�S',i.iui <br /> Abutting Lat Line �,�,a,y��; ;_±��,�2� <br /> N, S, E, W-;ad�Jn�c�n ft. <br /> 1•h'iikR '•SC1.Utl <br /> 1J:'tJ_k; ;-LS'.;�i�l <br /> Approved By t+i�+xrsn R. R'FiFAL <br /> City Engineer <br /> IMPORTANT! <br /> Issued By susy Yauqe:, <br /> CALL 1-800-424-5555 48-HOURS <br /> PRIOR TO DIGGING <br /> CALL'259-8611 FOR INSPECTION , <br /> Inspection By -��"'��"�— <br /> � _ Date l nspected � '�" �S <br /> SEE SKETCH ATTACHED N0. Z�O4O <br /> IP!�i'i_Cl'!Ci,l � <br /> i <br /> I�� <br />