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everetl <br />e <br />�ity of Everett <br />Sewer Applicatio <br />No. 27d47 <br />CHART N <br />Y- <br />1 <br />s <br />a: S� �� i <br />� ' {'� , .-; -i z <br />� ., f� Li - �", i:� J � � <br />.; � <br />» +� N <br />n an�ci Rerm�t_ ," '. <br />y <br />,; <br />=��- �d����! � <br />' - �_r -?z:�W�'"� i�:. <br />DATE _ hrr�la� j� 91A0 _ <br />Service Address , — <br />Billing Address 2420 198th Pl. SM <br />City, State, Zip Lynnwood, MA 980]6 <br />Owner (Mortgagor) b�xol• Con�truction <br />Billing Name B� <br />Connection By �e <br />Address eaae <br />Phone 77�-3256 __ <br />I DESCRIPTION: <br />; �ot � -- Block <br />� Plat __ <br />� Unplatte�.i Description <br />Type Permit: dw �� <br />I Remarks: <br />IMPURTANTI <br />CALL 1�800d24-5555 48�HOURS <br />PRIOR TO DIGGING <br />CALL 259�8811 FOR INSPECTION <br />SEE SKETCH ATTACHED <br />Utility Account No. <br />Permit <br />�c, `Josl.C�q <br />q_ �_��' <br />Connection Chargels) +�e_oo <br />Total Fee_.. ±a oe . <br />Uttlit.y Mrylo}aant F�a Ord. 1171-BS <br />vatet 179.00 <br />swar ��1.00 <br />650.00 <br />Signed � <br />CJf10Tlf <br />Sewer District �n;** _ <br />Monthly Sewer <br />Monthly Sewer Constr. <br />�70.00 <br />Lateral <br />Abutting Lot Line <br />N, S, E, W <br />Approved By <br />iry Enpineer <br />�SSUC(J By c .��, f(iHg�O - <br />i , � <br />� �. <br />Inspection By� � � � <br />Datelnspected_���- — <br />No. 2"1447 <br />I�::. . . �.!� , <br />