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everett <br />�� <br />City of Everett <br />S�W�2t' <br />- - =' �=; ; ` _ ,� '_ � <br />- 'T' =i = :. - :� � ;-i F. <br />u'i .. . . *' ' <br />�• 4: � <br />• , 0 1"= R � • � . <br />/a►�9�?IIG;Ci�'B�'I'i C�11� �r?e�tg9"11$ <br />r, _ _ � <br />,; - - '_ ���LL -'-- <br />NO. 21 �SQ' J DATE,=�n.�.r�eT—b94et• "� <br />Service Address sm i_ 9th A�s et <br />Billing Address_��;o�.yq,R <br />City, State, Zip �itm, t� t� 96Z75 <br />Owner (Mortgagor� ������F�maos, I�c <br />Billing Name r� <br />Connection Bv <br />Address_ <br />Phone gz�ry}91 <br />DESCRIPTICN• <br />Lot __ . Block <br />Plat Gleuhavctn Ata <br />Unplatted Description_ _ <br />Type Pennit: <br />Remarks: <br />IMPORTANT! <br />CA L L 1�800�424-5555 48�H0 U H 5 <br />PRIOR TO DIGGING <br />CALL 259-8871 FOR INSPECTION <br />SEE SKETCH Al'TACHED <br />CHART NO._ <br />lv CN�2T�tvCa <br />Utility Account No. <br />Permit Fee�,� _ <br />Conrection Charge(s) }}g:eg__ <br />Total Fee , .,.. <br />�rdinattcs I171—E; <br />water 224.Q0 <br />sower 589.00 <br />813.00 <br />Signed _ <br />Customer <br />/ <br />Sewer District_ pQ;�.� . <br />MonthlySewerService �yn_nn <br />Monthly Sewer Constr. <br />Trunk __ <br />Lateral <br />Abutting Lot Line <br />N, S, E, W <br />Approved By nr.r.aen n_ mr�err. <br />Ciry Engmecr <br />Issued By <br />Inspect�on E; <br />J RocY.woll <br />C� <br />Datelnspected_ ? / '� _ <br />No. 27654 <br />If��- , _ ;-i�i; � ,� <br />