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i <br /> i <br /> CHART N0. <br /> everett <br /> e s. �� �5��� <br /> �- 5 - 3a- 90 <br /> ,� <br /> Gity of Everett � 1 ,� <br /> i � ; o <br /> ,.. � <br /> ., .. <br /> Sewer Applic�tion;a�d Permit <br /> � -t J <br /> '� 1 � r' <br /> N0. Z?61O DATE- ^ �w � l�� loao <br /> Service Address 210 sQ 11Gth Pl_ 8E Utility Accc�int No. <br /> Billing Address S� _— Permit Fee_. �0.00 _ I <br /> City, State, 2ip_Zwrohl� �a oasoa Connection Chargels) � <br /> Owner (Mortgagor�_ch.:l.■ a_ w1t..� Total Fee �O.uO <br /> Eiilling Name su. _ <br /> Connection By_ �i:i�_ <br /> Address_ Signed <br /> Cvslomer <br /> Phone - <br /> DESCRIPTION: Sewer District <br /> Lot Block Monthly Sewer Service — <br /> Plat _ <br /> Unplatted Description_ Monthly Sewer Constr. <br /> Trunk <br /> Type Permit: „_.. ........_.,« <br /> Lateral <br /> Rema-ks: <br /> __. Abutting Lot Line <br /> N, S, E, W_ ft. <br /> i <br /> — -- Approved By_ I <br /> C�1y npi r <br /> IMPORTANTI <br /> Issued By____000_•- <br /> CALL 1�07-424-5555 48�HOURS <br /> I <br /> PRIOR TO DIGGING I <br /> CALL 259-8811 FOR INSPECTION / � � � I <br /> !� <br /> InsNection By <br /> ____ _ Date Inspected_ `�z� p�� ( <br /> SEE SKETCH ATTACHED Np, 2 1 G11O <br /> �,.. � ,: i !��;, � <br />