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everen <br />� <br />City of Everett <br />Sewer �p�lieatian <br />N0. 27��� DATE <br />�- <br />� <br />� <br />� <br />CY. <br />� �' :` :�t � i r� � � G <br />_ ,-, <br />�°` - � r - c <br />- _� ,=, .: :�, ' - <br />a. �—t .�� ..� .A ti � ` <br />ClIi�C� �t.'Cl'Xlt�' . .� <br />'�l LL �1 �-��i v�j 'yJ <br />� r <br />`_� � ' ' '�'J lq � —L~i � u ; v 2 � <br />�1 ...... _ �....W�.� �r.,2 <br />� npril 6, 2990 <br />Service Address �gl{, 9,y� �„Q <br />Billing Address yp��-,, ;_7Ag <br />City, State, Zip�W,� ���� <br />Owner (Mortgagor��,g� ���, <br />Billing Name �a� __ <br />Connection BY--l-.-- ---- - <br />Address <br />DESCRIPTION: <br />Lot�_ _ Block <br />Plat _Glan.`uuan Btc <br />Unplatted Description <br />Type Permit: <br />Remarks: <br />IMPORTANT! <br />CALL 1-800-424-555548•HOURS <br />PRIOR TO DIGGING <br />CALL 259-8871�FOR INSPECTION <br />SEE SKETCH ATTACHED <br />Utility Account N <br />CHART <br />1 c. ��� �-�G'- T� NL_-� <br />:: <br />a' <br />Ci <br />Y <br />y <br />j <br />Permit Fee ��,� <br />Connection Chargels)_� . <br />Total Fee��_ <br />ordinance ].171-(35 <br />water 224.00 <br />se�er 589.q0 <br />&13.00 <br />Signed <br />Cusromcr <br />Sewer Distric[ ���� � <br />Monthly Sewer Servi <br />Monthly Sewer Constr. <br />Trunk �1Q 09 <br />.4butting Lot Line <br />N, S, E, W. <br />Approvr,d By <br />ity ngineer <br />Issued By T FasYure�� <br />��L' <br />Insp�ction By� � <br />Date Inspected /G•-�%'6 <br />No. 2"T{i�1 <br />li!5': Ci!O��J <br />