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everett <br />� <br />City e} Everett <br />CHART NO. <br />,? F� - r� !<,u,+.. . <br />, <br />� <br />Sewer A,pplication and Permit �., 4,���- <br />� �,-z <br />�>� ��.�� <br />No. 25341 DATE �t ' <br />--Ooiob��9, 190i — <br />Service Address �_ _ Utility Account No._ <br />Billing Address_�.�i <br />City, State, Zip <br />. — <br />Owner (Mortgagor�� <br />Billing Name <br />Cannection Bv <br />DESCRIPTION: <br />lot _ Block <br />Plat <br />Unplatted Description <br />Type Permit: � rM���� <br />Remarks: <br />--�atd , <br />�ds-s��at�eontrivetleer-Ecigne� '�f-ZaT <br />�nrr)-b�►lae�-�i� 2I f°.6--��+Qi4t- 9L:'d <br />---- ?3gg--E`�r <br />_ <br />IMPORTANTI <br />C�LL 1A00-024�555548�HOURS <br />PRIOR TO DIGGING <br />CALL:59-6811 FOp INSPECTION <br />SEE SKETCH ATTACHED <br />Permit Fee _��p <br />/ i,• .-'F <br />Connection Charge(s�_ •ll �0 —� <br />Total Fee ____ <br />Sy�clal tltllity Fee, Ord, 1171-A�� <br />5688.00 <br />S�gned_ <br />c��,�o�, ----- <br />Sewer District AanA tii —.— <br />Manthly Sewer Service_ <br />Monthly Sewer Constr. <br />Lateral <br />Abutting Lot Line <br />N, S, E, W_ <br />Approved By <br />� r o��r <br />Issued By <br />Marqaiet r. MCI.�o -- <br />Inspectian By � � _ ^ <br />Date Inspected � I <br />rvo. 25941 <br />C:::i i �;�ii�!,. <br />