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i�': <br />:. <br />�."• <br />h <br />�•: <br />M1. <br />everett <br />� <br />City of Everett <br />$eVv�ier 14p►�EiGC!$Ic�n <br />No. 25934 D.ATE <br />ServiceAddress__inSpS - 9t;yTr C�__._ <br />Billing Address .nn a r,-��., re o>>., <br />City, State, �ip.. r,�,.,a T�.,�.�cLR2n2 <br />Owner (Mortgag�r�_ �n <br />Billing Name ��q <br />Connection By A�RM CTi]�f1 <br />Phone_ 38��-+� <br />DESCRIPTION� <br />Lot�_ Block — <br />Plat �,�.t ri„r i�-n� <br />Unplatted Description <br />Type Permit: <br />Remarks <br />1l'�i � <br />CALL 1-800-424-5555 48-HOURS <br />FRIOR TO DIGGING <br />CALL 259-8811 FOR INSPECTION <br />SEESKETCH ATTACHED <br />CHART N0. <br />�' i - , ��n Plrk,,,r=� <br />_ � - <br />� '� !'.; <br />� n :r <br />vj w1 <br />�; <br />�� �.�J _. .� <br />.1 � '�'.1 :J <br />r � _. � <br />Utility Account No. <br />Permit Fee zp,�n <br />Connection Charge(s) 725 00 <br />Total Fee �n nn <br />c`'�.7 S /8 S <br />Snecial utility foe, Ordinance 11T1-95: <br />Nater 179.00 <br />seo+¢r 471.00 <br />G50.00 Ij ;: �� � � � <br />Signed ��' ' ' <br />� ` <Customer <br />�1 <br />Sewer District ����� <br />Monthly Sewer Service <br />Monthly Sewer Constr. <br />Trunk <br />Laterel <br />Abutting Lot Line <br />N, S, E, W_ <br />Approved By <br />i y nginccr <br />Issued By , <br />� . C.�'� � <br />/ / <br />inspection By � � � <br />Date I nsper,ted � � � �� � <br />No. 25934 <br />I:.._I'L.C'IiCIfJ <br />