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everetl <br />e <br />cfty ot Everett <br />Sewer Applicction and <br />No. 27663 <br />� �� <br />�� <br />Perrnit� , � " � <br />� ��� <br />DATE 11�[aA 20 1l90 � <br />Service Address 91S - 112th /t E6 <br />Billing Address �e20 - 66th tt �s <br />Citti•, State, Zip =��lr R1► f820s _ <br />Owner (Mortgagor) ��'1 M�� <br />Billing Name � <br />Connection By ��d �K• <br />Phone 1!ldRM� �)7-A�S� <br />DESCRIPTION: <br />Lot <br />Plat _ <br />Block <br />Utility Account <br />CHART NO. — <br />TO POSTING �L-�6Ri <br />Permit Fee �-� <br />Connection Charge(s) "^-°^ <br />Total Fee "' °^ <br />oe�ein.no. u71-es � <br />wt�z 571.75 <br />�r 1515. s <br />fp 2090.00 <br />� <br />1' , `� , � <br />Signed --,�.-�•-� . <br />uftomer <br />U�pletted Description � �«+� - <br />Typa Permit: <br />Remarks: <br />IMPORTANTI <br />CALL 1�800�444-6565 48•HOURS <br />PRIOR TO DI(iGIN6 <br />CALL 269�8811 FOR INSPECTION <br />SEE SKETCH ATTACHED <br />Sewer District �d *** <br />Mon+hly Sewer 5ervice <br />Monthly Sewer Constr. <br />Lateral <br />Abutting Lot Line <br />N, S, E, W, <br />Approved By �*�� ■ '�'�`� <br />Citv Enpfnex <br />�ss�ed av r..s...c = �es.oa <br />.. <br />Inspection B� l / <br />Datelnspected_.� %Z <br />No. 27663 <br />INSP[CTION <br />