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i 1 <br /> i <br /> i <br /> CHART N0. <br /> eve*ett <br /> � r To i-i=sr�r�a <br /> � � S -78- �C^ I <br /> � � I� <br /> Ciry of [verett ` v ? <br /> ;.; � 1 <br /> Sewer ApRiication and Permit ' <br /> : <br /> No. 275545 � � � oc,-re r�,,,r�____'__'r-'°°� _ -- --- <br /> Service Address 129 - 112th S� __ -- Utility Account No. <br /> I <br /> Billing Address _,$�p�q —_-- Permit Fee 3fl:-09 — <br /> City,State, Zip [�ppp.u,�Vq 9S20A _ Connection Chargels) <br /> � Owner (�lortgagor) 0 Total Fee_� <br /> I � <br /> iBilling Name_ I <br /> Connection By gwq�• — _--- — I <br /> Address _ Signed — ' <br /> customer I <br /> � Phone <br /> � -- -- <br /> DESCNIPl ION: Sewer District_ — <br /> Lot_ Block Montlily Sewer Service_--- <br /> Plat <br /> Unplatted Description ___ Munthly Sewer Constr. � <br /> i <br /> _— Trunk ___ <br /> Typa Permit: _Unv �a��Atla�-txv�e <br /> Lateral � <br /> Rem�rks: LI� �719 -- Abutting Lot Line I <br /> N, g, E, yy it. <br /> ' <br /> -- <br /> — -- Approved By . <br /> ny. e ' <br /> IMPORTANTI J ��1aro11 <br /> Issued By I <br /> CALL 1�800-024'555 48�HOURS <br /> PRIOR TO DIGGING I <br /> CALL 2695811 FOR INSPECTION � � ! - � i <br /> /�� � <br /> Inspection By � <br /> --- —_-- — Date Inspected���'7 — <br /> SEE SKETCH ATTACHED ���. 27554 <br /> � <br /> i� ,i_C i l f <br /> i <br />