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evereM <br />e <br />City of Everott <br />Sewer Application and Permit <br />No. 25414 DATE �u�� <br />Service Address =M 97th Plaw t.i. <br />Biiling A�dress 1�M ls�oaAwy <br />City, State, Zip �rn�� � �•�• 98201 <br />Owner (Mortgagor) �b�° �1t7 <br />Billing Name <br />Connection By <br />Address <br />w�'__ isi'iis6 <br />DESCRIPTION: <br />Lat � Block _ <br />Plat �11 r.mr <br />Unplatted Description <br />Typa Permit: <br />Remerks: <br />IMPORTANTI <br />CALL 1AODd29•6556 48-HOURS <br />PRIOR TO DI(iGINO <br />f.ALL 26B88;1 FUR INSPECTION <br />SEE SKETCH ATTACHED <br />CHART <br />Utility Account No. <br />Permit Fee ��•� <br />Connection Charge(s) �]0.00 <br />TotalFee ��'� <br />orain.ao. u11—es <br />�� !t!� 17l.00 <br />�71.00 <br />650.00 <br />Signed <br />cuiromer <br />Sewer Oistrict �� III <br />Monthly Sewer Service <br />Monthly Sewer Constr. <br />ll0.00 <br />Lateral <br />Abutting Lot Line <br />N, S, E, W ft. <br />Approved By �• �• �� <br />CnrEnqmem <br />Issued By s' �ona <br />Inspection By ��![,�Aq��/ _ <br />v <br />Date Inspected �' �� "��O <br />No. 25414 <br />IfJ�i'CCl IOfJ <br />