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CHAFiT NO. <br /> everett <br /> e �- <br /> � <br /> z <br /> City oi Everett � � g g � g <br /> '" _' 3 :' �, o ' <br /> �, <br /> w �. :A N u~i <br /> Sewer Application an�.Re�rri�t �� <br /> � �� � i � � � <br /> �� W � � g � � <br /> Ax = ' �; � � � � <br /> 2���V � u � '� i y; � <br /> N0. DATE '���++ +eee <br /> Service Address 1137 100th B! SN 1166 Utility Account No. <br /> Billing Address $� Permit Fee +e_ee <br /> Cicy,State, 2ip ��t, 101 98t01 Connection Charge�s) <br /> Owner (Mortgagor) ��1���° Total Fee an eo <br /> Billing Name a� <br /> Connection By <br /> Address Signed <br /> customer <br /> Phone�SS-�7f1 <br /> DESCRIPTION: Sewer District �a =II <br /> lot�_ Block _ <br /> Plat*.�+w. e. .�.. rot.��. ne.. puk Monthly Sewer Service <br /> Unplatted Description Monthly Sewer Constr. <br /> Trunk <br /> Typa Permit: � �tiaa, aobil� ha�r <br /> Lateral <br /> Remerks: <br /> — Abutting Lot Line <br /> N, S, E, W ft. <br /> Approved By <br /> Iry Enpmea <br /> IMPORTANTI <br /> Issued By ��=q�t s MrLod <br /> CAL L 1�BOOd24-6565 48•HOURS <br /> PRIOR TO DIGGING <br /> CALL 269�811 FOR INSPECTION <br /> Inspection By <br /> Date Inspected <br /> SEE SKETCH ATTACHED N0. 267J8 I <br />� I P!;;P[CTI O;J <br />� <br />