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everetl <br />e <br />City of Everett <br />Sewer Applicction and Permit <br />N0. Lvo�� DATE L�3�,1987 <br />/�� rlSr S� <br />Service Address �'+ +�� d �! <br />Billing Address_1,3•�+;��.: Q• <br />City, SWte, Zip � ►�,� _pW00 <br />Owner (Mortgagor) *.+� r•--�-� n �awod— <br />Billing Name e••*• n� <br />Connection By y�aaoklw�C�s+Ncw <br />Address <br />Phone �+� �� • <br />DESCRIPTION: <br />Plat <br />Unplatted Uescr <br />Type Permit: <br />Remarks: <br />Block <br />INIPORTANTI <br />CAIL 1�800-024 �655 48•HOURS <br />PRIOR TO DIGGING <br />CALL 269�8871 FOR INSPECTION <br />SEE SKETCH A7lACHED <br />CHART <br />� SFivT To CNA�CTiA.� <br />� <br />� <br />�. <br />�Q�� <br />� �4�(" <br />O M w n <br />... <br />�..� ��, <br />.. ,� <br />� '���=� <br />Utility Account Nc. -- <br />Permit Fee ��•� <br />Connection Chargels) �30.00 <br />Total Fee m•� <br />prdinaaca Tte: �71.00 <br />Signed <br />c�.�o�, <br />7- 3/-8 7 <br />Sewer District � � Y � 1 / /T_ <br />Monthly Sewer <br />Monthly Sewer Constr. <br />Lateral <br />AbutU, Lot Line <br />N, S, E, W, <br />I APProved By HL1'1tID n_^n.w _-- <br />Gq Enpmrrr <br />I Issued 8y Marnaz�t,�_ nai,uac <br />� n <br />Inspection By <br />Datelnspected � � — <br />N�. 26071 <br />IfJ �PECTION <br />