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I CHART NO. ------- <br />everett <br />� d )C.✓T �p C!/n.['./it4; /f!�-fiL <br />F <br />� <br />City of Everett � — <br />tY <br />Sewer Applic�ti��n and Permit � "" <br />e � � ! .'.� <br />,r � �` � <br />] �� .Z ^ Y <br />N0. Z59OS DATE __— .,,,...,a,.,* L 1905 <br />ServiceAddress �1��� l��r� �'1.. G.C. <br />Billing Addres: <br />City, State, Zip ��tt N71 99204 <br />Owner (Mortgagor) Lcr�'on H. t'an'r �• <br />Billing Name_ S�s° . <br />Connection <br />F+hO�g 117 A07G <br />DESCRIPTION: <br />lot _ Block <br />Plat -. <br />Unplatted Descriptian_ <br />TYPe Permit: ��rw Ccrxx�ctl��n <br />Romarks: Paid t�� L:i. 71.� I�rccvnen�. M:;iJ. <br />invoi�r for side se.rr constructinn (sii <br />1:•aal rr�:t;tt_C� O�ite:} Lcfc;I� 11/c1/F.( .r_ <br />Gr•lis Str�x� <br />. : L` (1 � .:; � .`. r , <br />tvrrctt� kA 9B20i <br />IMPORTANTI <br />CALL 1-800-024-555548�HOUPS <br />PRIOR TO LiGGING <br />CALL 259�8811 FOR INSPECTION <br />SEESKETCH ATTACHED <br />Ulility Account No. <br />Permit <br />30. <br />Connection Charge(s) _ �� 330.00 __ <br />Total Fee 30.00 <br />Speclal U:ility Faer Ord. 1171685t $471.00 <br />Siyned_ <br />C��s W mr� <br />$CN'ff �i5[flCl ' '�,•+' � <br />Monthly Sewer Service_ <br />_ Monthly Sewer Constr. <br />l}' <br />Abut[ing Lot Line <br />N, S, E, W <br />11�fkcD f. Ifii:✓l <br />Approved By <br />Gry Enpmen <br />�1a',�..i(?i r.. �i;� :, .. <br />Issued By — <br />Inspection By — — <br />Date Inspected �'� ` �—��-- <br />No 2ssas <br />I;.. �. ,. <br />