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evesen <br />e <br />City of Everett <br />Sewer Applieation and Permit <br />No 2544 3 <br />DATE .�� `�-' <br />� <br />Service Address C/� � L ? � ���' <br />BillingAddress�l � � �vevG�CF�iv ( ,�+ <br />�r <br />City, State, Zip � �%"� ��L� <br />Owner IMortgagor)��- s�/� � .-� �"�+/-�T� - <br />Billiny Natne_ �� ��%�'P.. <br />Connection By � Q' <br />Address��� �G�eN/ � <br />Phone �� `7'' � '" Cr� � .3�i� _ <br />DESCRIPTION: <br />Lot Block— <br />Plat <br />Unplatted Description�� <br />/ <br />Type Perinit: <br />Remarks: <br />IMPORTANT! <br />CALL 1-800-424�555548-HOURS <br />PRIOR TO DIGGING <br />CALL 259-8611 FOR IfJSPECTION <br />SEE SKETCH ATTACHED <br />=�JT ; d DEAiI %y- <br />��,,�; .-.,, : � _, . <br />Utility Account No. Q - <br />Permit Fee ��� �— <br />Connection Chargels) - <br />O� � <br />Total Fee ___ �Q - <br />Signed ' ',�i - � ,% �< J �._ <br />Customer <br />Sewer District <br />Monthly Sewer <br />Monthly Sewer Constr. <br />Abutting Lot Line <br />N, S, E, W. <br />Approved By <br />Ciry Engineer <br />Issued By -' <br />Inspection By ��� ^ <br />Date I nspected 7 �� <br />No. 25443 <br />li.,.. -_.-i�ll,;i`� <br />Z <br />0 <br />� <br />.. <br />c� <br />m <br />�� <br />r-i �--1 <br />N 2 <br />m <br />mo <br />-� c <br />om <br />s� <br />m <br />oz <br />c <br />rD- i <br />r-. .. <br />--i ✓� <br />� <br />� <br />oD <br />� <br />=m <br />m� <br />� <br />or <br />c� m <br />Z N <br />m <br />z c� <br />-i r <br />. m <br />n <br />s <br />