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evereH <br />� <br />City of Everett <br />Sewer I�►pplicatir � and Permit <br />No. 25671 DATE __ Jnne 2. 1986 <br />Service Addresc �+� _��T1 ��— <br />Billing Address 1�16 - 119th pl se __. <br />City, State, Zip ��tt, 1PA 9820� <br />Owner (Mortaaaor) Jam�� R. ltnnn <br />Billing Name <br />Conr�r.ction <br />Address <br />CHART <br />.iE'.v7 7•-, CN<'c ri.� ic� G-/Z '/4 �. <br />,i i . <br />��' f <br />; . � <br />�._ , <br />Utility Account No._ <br />Permit Fee �o..nn ___— <br />Connection Charge(s) 330.00 <br />Total Fee 30.00 <br />Spsatal P�e, Ordinanoe 1171-06� <br />S�rar Only 400.00 <br />Signed__ — <br />c��,�o�ne, <br />DESCRIPTION: Sewer District �d ijI <br />Lot Block <br />Plat Wlonthly Sewer Serv�ce _ <br />Unplatted Description *.. �s7en�xff_n15_ppp� Mo�thly Sewer Corstr. <br />BL1C 001 p-000, Lot D BL1C 1 Trunk <br />Typa Permit: � ��r�M <br />Remarks: <br />IMPORTANTI <br />CALL 1-800-024•5555 48�HOURS <br />PRIOR TO DIGGING <br />CALL259A811 FOHINSPECTION <br />SEESKETCH ATTACHED <br />Abutting ..ot Line <br />N, S. C, W <br />I %+PProved BY�RR�ii. A. Ti��3. — <br />iry npinem <br />I Issued By w..�r.e p._ W,r�nA <br />� <br />Inspection By <br />Datelnspected � — <br />No. 25671 <br />IfJ, i'i Cllt)i J <br />