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�■ <br />everetl <br />e <br />City oi Everett <br />Sewer Applicction and Perm <br />N0. 26OZ3 DATE <br />CHART <br />Service Address +a • +�+-� Utiliry Account N <br />`Permit Fee <br />Billing Address <br />Connection C rge <br />Cfty, State, 2ip <br />Total Fee <br />Owner (Mortgagor) �a s�} <br />Biliing Name � / <br />Connection By � <br />1 Phone <br />DESCRIPTION: <br />Lot <br />Plat _ <br />Unpletted Deur <br />Type Permit: <br />aamxrks: <br />�� <br />11Ey Fee. OL'4• •�/��"�` <br />5400.00 <br />�'�� �er District <br />Monthly Sewer Service <br />� Monthly Sewer Constr. <br />IMPORTANTI <br />CALL 1�800-024•6555 48-HOURS <br />PRIOR TO DIGGING <br />CALL 269�811 FOR INSPECTION <br />SEE SKETCH ATTACHED <br />Lateral_ <br />Abutting Lot Line <br />N,$,E�W <br />qpproved BY — <br />CnY nqmeN <br />Issued BY <br />Ins�ection By <br />Date Inspected_ <br />No. 260`L3 <br />IP:'�.'I=i:IlOiJ <br />