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CHART NO. <br /> everett � <br /> � � <br /> City ot Everett � � � � � � � <br /> * ^ �; o o � � <br /> ' � r M w N <br /> .J <br /> S�wer Application and Pe��n�o � � � <br /> ; � . �, � � � � � <br /> ��� _ � � � _ � � � � <br /> No. 26305 DATE Juwn�t 2� 1997 __ _ <br /> Service Address Utility Account No. — <br /> Billing Address Permit Fee_ <br /> City,State, Zip Connection Charge�s) <br /> Owner (Mortgagor) Total F � +� 00 <br /> Billing Name <br /> Connection By <br /> Signed <br /> Address_ , c�,�o�� <br /> Phone <br /> DESCRIPTION: Sewer District <br /> Lot ��� Block Monthly Sewer Sen ice <br /> Plat s.ir... e.r.r�. — <br /> Unplatted Description Monthly Sewer Constr. <br /> Tru�k <br /> Typo Permit: <br /> Lateral <br /> Remarks: _. Abutting Lot Line <br /> N S E W ft. <br /> Approvcd By�, <br /> � ne <br /> IMPORTANTI Issued By <br /> CALL 7A00�24�555548•HOURS <br /> PRIOR TO DIOGING <br /> CALL 269$811 FOR INSPECTION <br /> Inspection By <br /> — Date Inspected <br /> SEE SKETCH ATTACHED No. 26305 <br /> IfJ"�PCCIIOfJ � <br />