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i evereH <br />I � <br />� <br />� City of Everett <br />Sewer Application and Permit <br />NO. ?5182 DATE ��1A,�05 <br />712 lOSth plac� d.E. <br />Sen�ice Address____ ___ _ <br />Billing Address �1� a•�•��tt p�ll Nar <br />City, State, 2ip ��tt, Na�hlnqton 9g2p� <br />Owner (Mortgai�or) �'0°�in CL�tew �1e�i �a. <br />Billing Name <br />Connection By <br />Address <br />Phone--.---- — 3S�-�S40 <br />DESCRIPTION <br />I_ot � Block <br />Plat �L'� p�s Dlt 2 <br />Unplatted Description <br />Type Permit: � �� <br />� Remarks� <br />� <br />S►'.E SKETCH ATTACHED <br />CHART NQ_ _. _ <br />Utility Account No._ <br />Permit Fee �0.00 <br />Connection Charge(s�_ <br />TotalFee ���� <br />Ordinanca 98�-8) <br />B00,00 <br />Signed <br />�� f,utibmv <br />� � , I� rti <br />Sewer Distncl__ __ __ _ _ BonA III <br />Monthly Sewer Servictr_____ 6.5U __ _ <br />Monthly Sewer Const��. <br />Trunk »��� <br />Abutting Lot Line <br />N, S, E, W <br />APProved BY-- �• �• '��1 <br />crtv e�yio�e. <br />Issued Bv �' �d <br />. <br />Inspection By r �, <br />Datelnspected_� � O �� <br />No. 25182 <br />c <br />� <br />� <br />m I <br />... .� <br />� �� <br />�+ �i <br />�' m <br />�`mo <br />-� c <br />o� <br />-i z <br />x -+ <br />m <br />.. <br />cz <br />�s <br />rti r. <br />� V� <br />� FT� <br />�� <br />x <br />m �� <br />v <br />r <br />m <br />�N <br />v <br />z c� <br />-i r <br />. m <br />n <br />� <br />-, <br />x• <br />D <br />z <br />i <br />�:' <br />� <br />�_ <br />� <br />� <br />