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everen <br />� <br />City of Evarott <br />Sewer <br />� <br />� <br />� � ���,�'��ir��' ��� <br />�� r <br />Applicati�r���d P`'err�'t� �,� <br />� � ������`���` <br />27435 � `° � <br />NO. DATE _ a�� 19. �tt <br />Service Addrass ��8 97th �t. it <br />Billinp Addreas =�S 11dtL �l. sN <br />Cfty, State, Zip L7°�• � ��6 <br />Owner (Mortgagor) =�Q�1i �=�O° <br />Billiny Name =� <br />Connection By � _ <br />Address � <br />Phone 77�-3]S� _ <br />DESCRIFT•ION: <br />Lot e <br />Plat <br />Unplatted Descr <br />Remarks <br />Block <br />IMPORTANTI <br />CALL 1AOOd24•6566 48•HOURS <br />PRIOR TO DIGGING <br />CALL 269�8811 FOH INSPECTION <br />SEE SKETCH ATTACHED <br />CHART <br />'^ "�c�ING�--�� <br />Utility Account No. _— <br />Permit fee ��•� <br />Connection Chergels) ��•� <br />Total Fee �0.00 <br />OLility D�lopM�t ►N Ord. 1171-65 <br />wl�t 1�9.�0 <br />pMs �71.00 <br />680.00 <br />Signed <br />cwtome, <br />Sewer District �d III <br />Monthly Sewer Service <br />Monthly Sewer Constr. <br />Trunk 3]0.00 <br />Leteral <br />Abutting Lot Line <br />N, g, E, W n. <br />Approved By �ilA6D B. 7�L <br />Ci1Y Enpine.. <br />�ssued 8y sn�r 6�uwn <br />Inspection B � / <br />Datelnspected v — <br />No. 27435 <br />WSPGC1lON <br />