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everett CHART N0. <br /> � SFNi� %O CHfii'iiit/� <br /> � �,G- -t�7 <br /> City of Everett <br /> S�wer Applicc�tion and Permit <br /> N0. ��Q�v DATE �rch 5, 1746 <br /> Service Address 12023 - 14th Dt`ive SE Utility Account No. <br /> Billing Address 1820d Iiothe2l Evt HdY P2 Permit Fee 30.00 <br /> City,State, Zip Bothell HA 98012 Connection Charge(s) �30.00 <br /> Owner (Mortgagor) Less1 eY Construc�ion Total Fee. 30.00 <br /> Sewer Ueve opmen ee - <br /> Billing Name Same ;later 179.09 <br /> Sew�r 471 .00 <br /> Connection By Same _ 650.OD <br /> Address i8204 Bothell Eet Hwv t2 ��'� ' <br /> Signed_--� <br /> Customer <br /> Phone 4R1-8866 <br /> DESCRIPTION: Sewer District <br /> Lot� Block <br /> Plat_�11Yer Lake V15ta Munthly Sewer Service <br /> Unpiatted Description Monthly Sewer Constr. <br /> Type Permit: Nev/ COnneCtion Trunk <br /> Lateral <br /> Remarks: <br /> Abutting Lot Lirie <br /> N, S, E, W ft. <br /> Approved By h. R. Thedl I <br /> City Engineer <br /> IMPORTANT! <br /> Issued By S Graqnarl <br /> CALL 1-800-424-5555 48-HOURS <br /> PRIOR TO DIGGING <br /> CALL 259-8811 FOR IR�SPECTION <br /> Inspection By ` <br /> — Date Inspected_ ��9/ <br /> SEE SKETCH ATTACHED Np, • t�J�r90 <br /> I PlSP[C�I �(V <br />