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everen <br />� <br />City of Everett <br />Se�rver Application <br />No. 25775 DATE <br />�, <br />� <br />� <br />� �8� �� <br />�„^�j .� Q r; 4'1 <br />r � y <br />r .+ � �i <br />r .. <br />an ��mi� o <br />� , �., � <br />� i����� <br />p 18. 1986 <br />Service Address � ���� 1]Atb�l s'a — <br />Billing Address �� — <br />City, State, Zip 4.+ •� v. aiZO� — <br />Owner (Mortgagor� ns * �«� <br />Billing Name <br />Connection By — <br />Phone <br />OESCRIPTION: <br />Lot <br />Plat <br />Unplatted Descr <br />Type Permit: <br />Remarks: <br />]37-0331 <br />Block <br />IMPORTANTI <br />CALL 1�800d24�555548�HOURS <br />PRIOR TO DIGGING <br />CALL 259�8011 FOR INSPECTIUN <br />SEE SKETCH ATTACHED <br />Utility Account No. <br />Permit Fee +o_oo _ <br />Connection Chargels) �m_on <br />Total Fee 3n.� <br />Ordlnanw 1171-95, s�vsr onl� 000.00 <br />Lal�ao�rra A9r�e�nt 2091.9r <br />Signed _ <br />cuttomer <br />$CWQf �ISifICI a+�A I7t <br />Monthly Sewer Service--_ <br />Monthly Sewer Constr. <br />Trunk <br />Lateral <br />Abutting Lot Line <br />N, S, E, W <br />Approved By �t•rrtt� n- 'rti°�i. — <br />citv F.npmem <br />luued By _�-M���*- �"^*�"� <br />Inspection by �"/I� ` <br />Da[elnspected___� �� ` �— <br />No. 25'l"15 <br />IfC:��'�.C�l I( �i: <br />