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,/� s CHART NO.— <br /> everett U _ �-LQ -� <br /> e �- � � <br /> , <br /> ���� � <br /> i�e5 � <br /> City of Everott I <br /> � <br /> S wer Application and Permit <br /> . �� <br /> l�� ' N�. 26113 DATE <br /> Service Address -S'1F' Utility Account No. <br /> Permit Fee <br /> Billir:a Address <br /> Connection Charge(s) <br /> City,State, Zip <br /> Total Fee <br /> Owner (Mortgagorl <br /> Biliing Name <br /> Connection By <br /> Signed Customer <br /> Address <br /> Phone <br /> Sewer District <br /> DESCRIPTION: <br /> Lot�— Block — Monthly Sewer Service <br /> Plat <br /> Unplatted Description Monthly Sewer Constr. <br /> Trunk <br /> Type Permit: Lateral <br /> /� /!7. / '� ? .7ur.c / �� <br /> /O � l.cum <br /> Remarks: �' rlp p� in � � Abutting Lot Line <br /> ' _o P o� S Y�. <br /> N S E W ft. <br /> � � .� T" �7�'�7' .Fa <br /> c'7/�/n'e a/Y/ /!7 <br /> iN t' ^J ~ '��� �' � APProved By <br /> City Enqineer <br /> P�", ' <br /> IMPORTANT! Issued By <br /> CALL 1-BOOA24-5555 48-HOURS <br /> PRIOR TO DIGGING <br /> CALL 2595811 FOR INSPECTION <br /> Inspection B � // � <br /> Date InspecTed� ��� o � <br /> No. 26113 <br /> SEE SKETCH ATTACHED <br /> UTILITY [31LLING <br />