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� CHAHT NO. <br /> everett <br /> e Y <br /> � <br /> � <br /> City oi Erera:t � g •� 8 S � I <br /> � � g . <br /> � .� y �7 i v I <br /> � Sewer Applicc�tion and Perr�#t� � � + <br /> � �`- � ��� � W � � <br /> 26124 N.�,�s,-�+�e�r '� � � � <br /> N0. DATE <br /> 1177 — 100th et BN 178 <br /> Service Address_ ��+�w����� Utility Account No. <br /> 8illing Address 239]0 Bvy 99 Permit Fee_ �n nn <br /> City,State, Zip ��. � 98020 Co�mection Chargels) <br /> Owner (Mortgagor) ar.a�raen �� Total Fee +n nn <br /> Billing Name_ A.�. <br /> Connection By <br /> Address Signed � � " -•--- <br /> Cutromer <br /> Phone __ »a_p�n� 1 <br /> DESCRIPTION: Sewer District n....a rII � <br /> Lot_ �e Block I <br /> Monthly Sewer Service I <br /> Plat �-��,.�, i�tat�s -- — <br /> Unplatted Description Monthly Sewer Constr. <br /> Typa Permit: Trunk <br /> �Mn �a�n�etien Nobile Hoos <br /> Lateral <br /> Remarks: <br /> Abutting Lot Line I <br /> N, S, E, W ft. <br /> Approved By <br /> iry �Ymee, <br /> IMPORTANTI � <br /> CALL 1AOOA24-F66648-HOURS Issued 8v p�q��� R M�� i <br /> PRIOR TO DIOGING <br /> CALL 269-6811 FOR INSPECTION <br /> Inspectipn By <br /> Date Inspected <br /> SEE SKETCH ATTACHED Np, Zs1Z4 <br /> IPJ:;I�[:c;l l('.'J I <br />