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everett <br />� <br />City of Everett <br />Sewer <br />rJ <br />—� ... �J�G. � — ,—_ � <br />. G' <br />y :,;�;=.:o ' o�� <br />_ _ ;, � ;;.. _. �.� � .-, <br />. , 1. .. .. Nr :a� ,w �.�a <br />L'i .i � . <br />Application a�c��ermat; ��; � <br />� ,, �� .. :� -`: �:� ,� <br />r' �u.� ::u'`�r�'�''„��'z?:3 <br />.-�.'c�,�`n:a�s� �-.-.: � :� <br />No. 27541 DATE �- Hn*rl� 6�oon <br />Service Address , , — <br />Billing Address_.. , <br />City, State, Zip <br />Owner (Mortgagor) <br />Billing Name <br />Connection By�-- - <br />Address <br />Phone <br />DESCRIPTION: <br />Lot <br />Nlai <br />Unplatted Description <br />Type Permit: <br />Remarks: <br />Block <br />IMPORTANT! <br />CALL 1�800-424•5555 48-HOURS <br />PRIOR TO DIGGING <br />CALL 259-8811 FOR INSPECTION <br />SEESKETCH ATTACHED <br />CHART NO. <br />To Posz-� tac� <br />��z,, g. �o <br />� <br />Utility Account No. <br />Permit Fee zp..p0 <br />Connection Charge(s)��n �n <br />Total Fee �� �� <br />Utility Developaent Fee Ord. 1I71-65 <br />vatur 179.OG <br />seKer 471.00 <br />650.00 <br />Signed .__ <br />Sewer District_uw,,..,aa� <br />Mnnthly Sewer Service <br />Monthly Sewer Constr. <br />Trunk <br />Lateral <br />Abutting Lot Line <br />N, S, E, W <br />Approved By , <br />nv� oyl tr <br />Issued By <br />�vV i� <br />Inspection By <br />Date I <br />INSPECTfOi`, <br />�-f=r'io <br />No. 2754�. <br />