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CHART N0. <br /> everett <br /> � <br /> City of Everett <br /> Sewer Applicati�n and Perrnit s��� T� �NA�'„� .� /5/�� <br /> No, 25549 DATE March 26, 19A6 <br /> Service Address � 513d — 15th Atra W Utility Account No. <br /> Billing Ac+dress 18204 eothall—Everett xw A2 Permit Fee_ 3p,00 <br /> City, State, Zip Hothell, WA 9II012 1'�onnection Charge(s) none <br /> Owner (Mortgagor�. Le�slev Canstzuctior Total Fee_ 30.00 <br /> I Billing Name Same S�eciai Poaa, Ordinance 1171-a5 <br /> dater ortly 224.00 <br /> Connection By Same <br /> Address Signed � <br /> Customer <br /> Phone A81-8t356 <br /> DESCRIPTION: Sewer District <br /> Lot ln _ Block_ <br /> Plat —.,;�„__ .. Monthly Sewer Service <br /> =a�.�c.ee3e 6,}ea <br /> Unplatted Description Monthly Sewer Constr. <br /> Type Parmit: Trunlc <br /> Lateral <br /> r�emarks: <br /> Abutting Lot Line <br /> N, S, E, W f<. <br /> Approved By <br /> Ciry Engineer <br /> IMPORTANT! <br /> Issued By <br /> CALL 1-800-424-555548•HOURS <br /> PRIOR TO DIGGING <br /> CALL 259•8t211 FOR INSPECTION <br /> Inspection By/- �'�Q/��`� _ <br /> Date Inspected ��� � � ____.__._ <br /> SEESKETCH ATTACHED <br /> NU. ZJ���J <br /> If�iSPECTi0i�1 <br />