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Ievereft CHART NO. <br /> e � <br /> City of Everett ie <br /> � $ g g � � $ <br /> � � ; �� ` <br /> Sewer I�pplication ond Permit � , � � ��� � .� r � � " � <br /> No. 26516 ;� � � � ��'�� �� � <br /> DATE �,.._..__ ��� ��p <br /> Service Address_ 11=7 100lh � g <br /> M—�— Utility Account No. <br /> Billing Address Y�s„ <br /> Permit Fee �n en <br /> City, State, Zip l�tt, � y82a <br /> --_ Connection Charge(s) <br /> Owner �Mortgagor) prs • Htsd � <br /> Total Fee_ i� � <br /> Billing Namei_aa <br /> Connection By err <br /> Addres: <br /> Signed - <br /> Phone c��ro�, <br /> DESCRIPTION: <br /> Lot� g�ock� SewerDistrict <br /> Plat !'�lewv i�taG� Monthly Sewer Service � <br /> Unplatted Description I <br /> Monthly Sewer Constr. <br /> Type Permit: <br /> Trunk I <br /> Remarks: Lateral <br /> Abutting Lot Line <br /> _ N. S, E, W ft. ' <br /> I <br /> I <br /> Approved By����� I <br /> IMPORTANTI ��v E�°�°°„ <br /> �Al.� 1�800d24•656648-HOURS Issued By <br /> PRIOH TO DIGGING <br /> CALL 269$811 FOR INSPECTION ' <br /> I <br /> � <br /> Inspection By_ � <br /> Oate Inspected_� � <br /> SEE SKETCH ATTACHED NO. 26.516 <br /> IfI: l'f_�i' ilU.' � <br />