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everen <br />� <br />City of Everctt <br />Sewer Applicatiom arid Permit <br />CHART NO. <br />jE'.✓T 70 cHsJ.C!.y� <br />/2 �3 cj/g � <br />N0. �`��JV DATE �j�f% 11> 1906 _� <br />Service Address 8904 -��th nve SE Utility Account No. <br />BillingAddress 1]i_SE-E1f�S�.** b'�� �"J <br />City, State, Zip tvornrt wn aa9nQ <br />Owner (Mortgagor)��S <br />BillingName �•�- <br />Connection By — <br />Address <br />Phone ?�� �� <br />DESCRIPTION: <br />Lot 5 Block — <br />Plat war nt., �5 <br />Unplatted Description <br />Ty�e Permit• <br />Remarks: <br />IMPORTAN'r! <br />CALL 1•800-424•5555 46-HOURS <br />PRIOR TO DIGGIhG <br />CALL 259-5871 FOR INSPECTION <br />SEE SKETCH ATTACHED <br />Permit Fee in Mh'"s�Fsr; '�t•.QF,ri �Nb]AlIDb2n k4l t <br />Connection Chargels)�'�g�,�— <br />G 6RCN 51.EJ1 <br />Total Fee �n nt5 �'c�ru � iti � — <br />Special Sewer Fee� �''4rd. 17�1=lJS <br />4later +�E"; 22�ti�ACJ <br />Sewer ���-�� 58'�.d&7 <br />I;{.'�4lV Ei�3. <br />-�d `r <br />�'�..1'� i�(I . ..'.! <br />Signed— - �;,,7n �,,'g �in- . <br />c�:;S°��f' =3U.UG' <br />Elli)Iil #33q.U0 <br />11"rl-5 cU13.W <br />Sewer Distrifj�____E.} � • �, - <br />Monthly Sewer <br />Monthly Sewer Constr. <br />Trunk <br />I_ateral <br />Abutting Lot Line <br />N, S, E, W <br />Approved BY S1 Thsa1 <br />City Engineer <br />Issued 8y S. C,rannan <br />Inspection 8y ' "- <br />Date Inspected � o�� 7 ��Ca <br />INSP�CTION <br />No. 2ssso <br />