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CHART N0. <br /> everetl _ I <br /> e � <br /> � � <br /> � � <br /> �, <br /> City ot Everett r '� � g � � <br /> � N q �j l Y^ � <br /> � � '� � ti <br /> . e� r �n � <br /> Sewer Application anc�eir�it� 4 � `� <br /> � y„_ � : � � � $� � � <br /> Y � ~ � <br /> I No. 2S4A5 DATE uow�r 5 '987 — <br /> Service Address Utility Account No. — <br /> Billing Address <br /> Permit Fee 7° °° <br /> City,State, Zip_ <br /> Connection Chargels) <br /> Total Fee ln °° <br /> Qwner (Mortgagor) I <br /> Billing Name I <br /> Connection 8y i <br /> Signed ��,o�� <br /> Address <br /> Phone -- I <br /> Sewer District r.oA •TT <br /> DESCRIPTION: <br /> ' Lot 1�7 Block Monthly Sewer Service <br /> Plet r•��• <br /> _Monthly Sewer Constr. <br /> Unplatted Description_ - I <br /> Trunk <br /> Typa Permit: Lateral <br /> Remarks: Abutting Lot Line <br /> N S E W �t. <br />' � <br />, I <br /> __ Approved By •���^ t �"��* I <br /> - CIIy E�pi�en <br /> IMPORTANTI Issued By I <br /> i �q�1.1�00424-6666 48�HOURS I <br /> PRIOH TO DIGGING <br />� CALL 269A811 FOR INSPECTION <br />' Inspection By I <br /> Datelnspected <br /> No. 26445 <br /> SEESKETCH ATTACHED � <br /> I; :'.;i'f��'��I(�pJ � <br />