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everett <br />� <br />City of Everett <br />Sewrer <br />� <br />� <br />� <br />:c -g�s�i��i u' �� �� <br />i_ "�vi.�r;�{c .�.�.� q^i <br />�7 J 7� f� ek'^'* id Ci :�? �%.—� <br />i^f� L.' b1 ili .# t'�. \: T" S� <br />� M� "� <br />A�p�ieatiQn ��nd Q�er i�. t� „ <br />T. � <br />i, �., <br />� ���_���������w� <br />=.��� �����:��z <br />,�� <br />CHAR'i <br />S�. � ,fn c/i�v ._��;, ;�'e/ss <br />No. 25997 D�TE«��,.�-�-br-�9A� �— <br />Servi;e Address ���� Utility Account N�. <br />—�,,-- t}t#t-M^ernfe-�.rE— <br />Billing Address ++��L -���� ��' <br />City,�tate, Zip <br />Permit Fee 38 89 - — <br />Connection Charge(s) . <br />Owner (Mortgayor�_��.v� , Total Fee <br />Billing Na <br />Connection <br />Address <br />Phone <br />DESCRIPTION: <br />Lot �__,�— Block <br />Speclal UL11ity Fee Urd. 1171-R5 <br />Sewer 471.00 <br />Nater 179.00 <br />b5f1.()0 � <br />Signed ' � <br />Custcmer <br />i <br />Sewer District��zi-- <br />Monthly Sewer <br />Plat .��� � <br />Unplatted Description Monthly Sewer Constr. <br />Type Permit: .._ *��n — <br />Remarks: <br />IMPORTANT! <br />CALL 1�800-424•5555 48-HOURS <br />PRIOR TO DIGGING <br />CALL 259�8811 FOR INSPECTION <br />SEE SKETCH ATTACHED <br />Trunk <br />Lateral <br />Abutting Lot Line <br />N, S, E, W. <br />Approved By <br />�i5 � e. <br />Issued By_§;; <br />Inspection By <br />pate Inspected '�7'"�S -- <br />ir�sp�c i ior� <br />rvo. 2�99� <br />