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r <br /> i <br />�.:_ '� � <br />� � <br /> � ;I <br /> I� I <br />� ! <br />�' , i <br /> CHART N0._ I <br /> eVC�en �LT1T Tr C_�1-rl�<'-�I ,l,'4. I <br /> � ll -?'-1-�$r� �� <br /> � <br /> City of Everett � i <br /> �ewer Application and Permit ! <br /> No. 27043 DATE �• �� <br /> �Y-�3-, �9£�? <br /> Service Address e��F a�h � m Utility Account No. <br /> BillingAddress g._7 �� � Gi,���� glvd ;917a PermitFee 3o_no <br /> City, State, Zip_�e�i}��y, y� �pZ� Connection Charge(s) *b+++.. <br /> Owner (Mortgagor) 3.q��_ Totai Fee ao_on <br /> Billing Name 6aae tltility Develogment Fee orQ. 1171-OS <br /> �mtor 179.OQ <br /> Connection By Seae serrer 471.00 <br /> 650.00 <br /> Address__ Sa•ae Signed --- --- = ` - <br /> Customer <br /> P�;one 392-9105 <br /> Q�SCRIPTIUN: Sewer District ilJr'.:,3�>.^i �:4•iPfi OptJf;ti�l.'•�'l i 's `' I <br /> i <br /> t_o? } Block ���t�� � <br /> Monthly Sewer Servf�� <br /> P!9t IdiFTEli 4�tip,(N) <br /> 41���' I <br /> Unplatted Description Monthly Sewer Con�!!'. " �? ! <br /> �4ki1' :.''>O.iAJ � ' <br /> — Trunk il�l`; :b;U.E10 <br /> Type Permit: i;i)OU;il�i]3 <br /> Lateral F:LfG :,43„u0 <br /> ltE�t; ��iS.iN I <br /> Remarks: Abutting Lot Line t�'��' ��'�'•'�� I <br /> N S E W I' :iRCN a:3.�d1 ft I ' <br /> r�. . . -:.t�.� � �� <br /> URVWY �'y7,i.�l <br /> i;NEt:i`. C't::l`:',.Dii <br /> — Approved 6y <br /> City ngineer <br /> IMPORTANT! <br /> Issued By ^aR; ltnu�er� — I <br /> CALL 1-800-024-5555 48•HOURS - <br /> PRIOR TO DIGGING i <br /> i <br /> CALL 259-8811 FOR INSPECTION i �. <br /> Inspection By �"_'� � <br /> Date Inspected � �^��� I , <br /> SEF SKETCH ATTACHED VO 4���3 ' I� <br /> � <br /> I��!�"r'EC��li,i � � <br />