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CHART NO. <br />evereti <br />� <br />City of Everett <br />`x��aT i�, i-t,�i�uC� <br />�I�OI�)G <br />Sewer Appiicatiar� and P�rr�it <br />NO. G� r 73 DATE T���� �F, to�n � <br />Service .4ddress— ����Q e���f, r,,� Utility Account No. <br />Billing Address R--.- <br />City, State, ZiP Ever*a��� i�� 96^6� <br />Owner (Mortgagor�_;��€ed-€e� <br />Billin� Name ..0 �_�g <br />Conne�tion Bv <br />Phone <br />DESCRI?TION: <br />Lot __ <br />Plat _ _ <br />Unplatted Descripti <br />Type Permit: <br />Remarks: <br />Block <br />IMPORTANT! <br />CA L L 1-80G-424-5555 48-HO U R S <br />PRIOR TO DIGGING <br />CALL 259�8811 FOR INSPECTION <br />SEESKETCH ATTACHED <br />Permit <br />Connection Charge�s) �qp_� <br />Total Fee 3�-nn <br />L'tility L'evelop;aent Pao Ord. 1171-85 <br />sewer 471.Ob <br />Signed — _ <br />cu;tomer� , <br />Sewer District Bond i:'i <br />Monthly Sewer Service <br />tJ�, .'ci 8�1 � ....,�,F'if ! o_.._'�i;,. � .._ . � i . <br />Monthly Sewer Constr. � <br />F�S'.tip2t,Ti �- <br />Trunk `.'kL�f' +j,.(`;; <br />t;i';�t.i! .��P.'�.i`� <br />Lateral �1:1-'_ s..i'r.i.i;t? <br />�-�Y:�1�, ,�,=1.ub <br />Abutting Lot Line <br />N, S, E, W <br />Approved By * �t.p� <br />Ciry ngineei <br />15sued By �,*_,.�ri;a�ye� <br />G' , c, / //r <br />Inspection B _ <br />Date I nspected �/��� <br />No. 2�77� <br />_ -.�..f� <br />0 <br />