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, <br /> CHART NO. <br /> everett S�N�- iv �•�,� � �i�-4/ <br /> � <br /> �J <br /> Y <br /> � � 4� <br /> Clty of Ev@rett a o � <br /> x � <br /> Sewer Application and Per�ni�„ ,_ <br /> �l � �, � <br /> � � � <br /> � ��.. � _, <br /> NO. 2$2$� DATE N.� 22_ 1991 <br /> Service Address 1oD20 7th Aw SE Utiliry Account No. � <br /> Billing Address �f�''d x•� <br /> City,State, Zip 10.1�n �rw yN ga Permit Fee $ 30.00 <br /> Owner ��eeaEE 1f11 9t06� Connection Charge <br /> Connectfon by �►•N• ��=+1 ConstYnet°n 7runk $ <br /> Address 17�� ��•F n� � Lateral $ <br /> ���_��� � ggpg; — Total Connection Charge $ <br /> Phone 334-2140 or ]3t-41�� Utility Development Fee <br /> Legal Description: Water $ <br /> �t Sewer $ <br /> Block Total Development Fee $ -- <br /> Piat '� <br /> Unplatted Description: Sewer Bond District <br /> Abutting Lot�ine <br /> N�g� E�yy ft. <br /> Type of Permit �... .....�-�•+�.+ .+� �zi.c �Q Approved By <br /> Remarks buildinq, LID 730 IssuedBy_ � gasr�lteL�od - - <br /> Customer Signature <br /> IMPORTANT! <br /> CALL 1-800-424-5555 48-HrJURS <br /> PRIOR TO DIGGING � <br /> Inspection By ( /> �.� �� <br /> CALL 259-8810 FOR INSPECTION / / <br /> Date Inspecied �(�-� ( �� <br /> SEE SKETCH ATTACHED NO. Z$Za7 <br /> INSPECTION <br />