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everen <br />e <br />City of Everett <br />Sewer Application and Permit <br />No. 25486 DATE �yKh 3� lOBL <br />Service Address�.. 9�t11 Pl SE <br />Billing Address ��29 Bro�Alyr <br />City, State, 2ip�u�it* Y� gg�p] <br />Owner (MortgagorS���NI� <br />BillfngNemB_SOyd�4 iM1L� <br />Connection By_sa� _ <br />Address— UY9 broadM�� <br />Phone i6Z-116f <br />CHART NO. <br />l�'+'J% TC c'�.�A,�r,.�.s- :jaB <br />Utility Account No. <br />Permit Fee.�_ <br />Connection Charge�sl��.� <br />Total Fee _ <br />Seae� Dev Fee 1171-85 224.0�1 V.ter <br />58�,�00 Sawa� <br />Signed <br />a�:�o�,«, <br />DESCRIPTION: Sewer District <br />Lot�_ Block_ <br />Plet,�� Monthly Sewer Service <br />Unplatted Description Monthly Sewer Constr. <br />Type Permit <br />Remarks: <br />IMPORTANTI <br />CALL 1ACOd24•5566 48�HOURS <br />PRIOR TO DIGGINO <br />CALL269A811FORINSPECTION <br />5EE SKETCH ATTACHED <br />Trunk�_ <br />Lateral <br />Abutting Lot Line <br />N, S, E, VI <br />Approved By <br />c� f ,e <br />Issued By <br />Inspection By '""^�e" <br />Date Inspected ��� <br />rvo. 25486 <br />INGP[CTIOfJ <br />