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evereri <br />e� <br />City of Everett <br />Sewer Application cnd P�rmit <br />CHART <br />�y.,� �� �� �/'•.'''.'� � � � t /�- 8 S <br />No. 26553 DATE F�t�,� �'+, �oar � <br />Service Address Utility Account No. <br />, ., <br />Billing Address —' <br />a.�rPht��j�� noonA — <br />City, State, Zip <br />Permit Fee 30.�0 <br />Connection Chargels) �iOnQ <br />Owner (Mortgagor) Fa r a � "' '' "'^'"-•` <br />Total Fee 30. <br />Billing Name <br />Connection By <br />Phone <br />DESCRIPTION: <br />Lot <br />Plat <br />Unplatted Desci <br />Type Permit: <br />Remarks: <br />Block — <br />IMPORTANT! <br />CALL 1-800�424•5555 48-HOURS <br />PRIOR TO DIGGING <br />CALL259-8811 FOR INSPECTION <br />SEE SKETCH ATTACHED <br />SignCd Customer <br />Sewer District �nd III <br />Monthly Sewer <br />Monthly Sewer Constr. <br />Lateral <br />Abutting Lot Line <br />N, S, E, W <br />°i•;i`il Ui!�_Rii^:",, :t <br />u.: `. _. '�;,: • � <br />� marnt. <br />AppfOVBd By �, � ,Q���eer <br />�."i. 1 <br />���.R�: i,:U. �1 <br />[._ i C�,:! t'�1 <br />Issued By Susv Hat�Pn <br />Inspection By –� <br />Date Inspected v –� 6 – � � <br />No. 26,�i53 <br />Iid'.;'!:C �lG�:! <br />