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i <br /> CHART N0. <br /> evereN �� -f�, �i� :,,'.--� 7 2 �-8B <br /> � P; <br /> City of Everott � 8 8 Si S 8 R 8 8 8 8 <br /> � .°.' � � '�^ � 3 � 4 <br /> ^ � r. r « r .. .. '. � Q <br /> � f .+ <br /> Sewer Applicatior� and Perr�it� � ; � � <br /> n � �� � � � � � � � � � = � <br /> NO. `s��� DATE <br /> Service Address � � �' ���� ��- S� Utility Arcount No. i <br /> Billing Address ��S}�— Permit Fee � �� <br /> ��ity, State, Zip �S� Connection Chargels) +,^n nn <br /> Owner (Mortgagor) �����* Total Fee 1p �� <br /> Billing Name � 8p�a1�1 ! U!lliiy t�• Ord. 1171-85 <br /> rat�r 179.00 <br /> Connection By •�r�r �71.00 <br /> 650.00 <br /> Address Signed <br /> cu,�ome, <br /> Phone�}s <br /> DESCRIPTION: Sewer District .-_. ++� <br /> Lot 1� Block <br /> Monthly Sewer Service — <br /> Plat *-��■se p1.e. <br /> Unplatted Description Monthly Sewer Constr. <br /> Trunk »0.00 <br /> Typa Permit: p�r Conn�o!!on <br /> Lateral <br /> Remarks: <br /> Abut[ing Lot Line <br /> N, $, E, W ft. <br /> ' Approved By. <br /> i1 n me <br /> IMPORTANTI <br /> Issued By �n�t Ifaaq�n <br /> CALL tA00d24-6666 48•HOUHS <br /> PRIOR TO DIGGING <br /> CALL 269�8811 FOR INSPECTION , <br /> Inspection By <br /> Datelnspected —�2� <br /> SEE SKETCH i.TTACHED N0. 26474 <br /> li•;GPf..0 I IOf! <br />