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everetl <br />I� � <br />i <br />City of Everett <br />Sewer Application and Permit �� <br />Ei�iAS <br />No. 25137 f�ATE _ __ - - - - - <br />Servic� Address �0) lOGth Pl� s.E. <br />Billing Address 1701Y 15th N.B. _ <br />City, State, 2ip ��ttl�, 1ia. 9e1S5 _ <br />Owner (Mortgag�� ���1� �' <br />Billing Name 8� <br />i Conner.tion By_— — <br />IAddress — <br />I�, Phone �67-0�16 _ — <br />� <br />i DESCRIPTION: <br />Lat _»__— Block <br />i Pl�t ���r i�w� _ — <br />I Unplatted Description -- <br />� TYPe Permit: �r Cona�otlm__ . _ <br />Femarkt: <br />! --- -- <br />I', SEESKETCH ATTACHED <br />CHARTNO.-_ -_- <br />Utility Account No. — <br />30.00 <br />Perm�t Fee _ -- — <br />]70.00 <br />Connection Chargelsl_---. <br />30.00 <br />Total Fee_. ------ <br />Ordin�nc�a 98{-8) <br />800.00 <br />i <br />Signed /' <br />/� <br />C�ntomer <br />DonA II2 <br />Sewer District <br />6,50 <br />Monthly Sewer Service — <br />__ Monthly Sewer Constr. <br />�I0.00 <br />— Trunk — <br />� I_ateral __ <br />r�r � '�r��. <br />Abutting Lot Line <br />N, S, E, W__ <br />1�. R. TM�1 <br />Approved BY_ <br />Cnv Ena���en <br />1!. sOeA <br />Issued BY - <br />Inspection By � �-' <br />� -- <br />- <br />Datelnspected__� �/-� -- -�---- <br />��� 2513T <br />u <br />z <br />0 <br />� <br />� <br />m <br />� 'T� <br />.. -� <br />�m <br />v <br />in o I <br />n i <br />1c� <br />o� <br />�_��~ <br />.-. <br />oz <br />c <br />�� <br />f. .S. <br />�� <br />< <br />� <br />�i i <br />-� � <br />m .- <br />� <br />r <br />m <br />c v+ <br />�� <br />s �� <br />-� r <br />. m <br />a <br />A <br />2• <br />D <br />z <br />� <br />� <br />� <br />�, <br />r <br />r <br />