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everett <br />� <br />�:IL�/ Oi EVBfBtt <br />Se�nrer Application and Permit <br />NO. Z�RSO DATE v..���.-� � �ona <br />$ervice Address_. �l�% ll.(:�� St. �.E. <br />Billing Address_ 5++� <br />City, State, Zip �ntt NA 98�04 <br />Owner (Mortgagor) 11x.m:,, h. Lux <br />8illiag Name uun <br />Con�ection By -- <br />Phone +'+� iaaa (�� --- <br />DESCFIPTION: <br />Lot _ _ <br />Plat <br />Unplatted Descr <br />Typa Permit: <br />h�a COnr�e•ct1.,r <br />Remarks: Paid Ly LllJ 719 <br />r+sil <br />inv.ice Yor slde sexer canstruct.l.on (si6n <br />]nyal prr{ie:ty uwi�er) lxxfure Il/:'1/H6 tu: <br />Cella Stirny <br />2Q0 Cc�!:�r St. <br />Evcic[t, wA t=6�G1 <br />IMPnRTANTI <br />f,ALL 1A00-02J�555548-HOURS <br />PRIOR TO DIGGt�!� <br />CALL 2598811 FOR INSPECTIOA <br />SEE SKETCH ATTACHED <br />CiiART <br />.S�% %� 7C !NF'i /+e.> /i /' f�L <br />Utility Account No. _ _ <br />Permit Fee �n_nn -- •----.- <br />Connectinn Chargels) �3n_no _ <br />Total Fee _ 3D.o0 <br />S�-+eciel Otllity Fee, Ord. 1171-05� 5400.00 <br />Signed <br />cusion <br />Se;ver District ,�,J�,_ <br />Mont�Jy Sewer Service. <br />_ Monthly Sewer Canstr. <br />-- Trunk <br />Lateral_ _ <br />Abutting Lot Line <br />N, S, E, W__ <br />/1LFRCi! ". IiR.AI. <br />Approved By —_ <br />Ciry Enqmee. <br />���ru.�nt F., ►rLex' <br />Issued BV — <br />Inspectiep���� — <br />p,rn I nspected 1�' V�� --- <br />No. 25880 <br />li:` P'�C i IO�J <br />