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CHART NO. <br /> everetl � ,/ <br /> e;;,,9�.�'!r, l`!rv'•' ,� '�13/88 <br /> � <br /> City of [verett <br /> Sewer Application and Permit <br /> No. 26�53 DATE B.ora��r 22- �a�7 - <br /> Service Addreu_ 1715 - IOOth Tl sE Utiiity Account No. <br /> 9S0] 19th �t� 8= Permit Fee 70 00 <br /> Billing Address — � qid !ar bp <br /> City,State, Zip M�+� b► 9s2M Connection Chergals)_ - <br /> Owner (Mortgagor) � ����= pi'O��« — Total Fee_ +� ^^ — <br /> 6p�a1�1 tltllity M, Oed. 1171-BS� <br /> Billinp Name �r� vebr 17�.76 <br /> .w.: tse.o9 <br /> Connection By = d=�����'OO 6�1.t5 <br /> Address 9507 19tli 11w UE E�'�tett Siyned c�w�� <br /> Phone �77-760! <br /> DESCRIPTION: Sewer District Ha�d II= <br /> Lot � Block Monthly Sewer Service <br /> Plat <br /> Unpletted Description Monthly Sewer Constr. <br /> Trunk <br /> Typa Permit: <br /> Lateral <br /> Remarks: Abutting Lotx nq <br /> N S �JW�/0'1/b�;�USFF100(laNi464 �{,11 <br /> � <br /> qQW1N531 <br /> Hl.D6 t11oi.:i0 <br /> B !�(:fl 13.50 <br /> Approved By_��"'���— T�� <br /> �94{' <br /> !iCM:N s70.0U <br /> IMPORTANTI Issued By M.�'e�� �}_ �j� — <br /> CALL tA00�424�6555 48-HOURS ��A��f9 I <br /> PRIOR TO DIGGING W1FF li:U.W <br /> f�u , s.;.w � <br /> CALL 269A871 FOR INSPECTION �`W� � i41•�� I <br /> Inspection By � " �--- i <br /> Datelnspected� `" <br /> SEE SKETCH ATTACHED Np, �L6353 <br /> �����:f'f f'1I('�'� <br />