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CHART NO. <br /> everett <br /> ,e. <br /> City of Everett <br /> Sewer Application and Permit <br /> No. 25973 DATE — +7ri9ee ---- <br /> Service Address Utility Account No. — <br /> Billing Address_ Permit Fee 30.00 <br /> City, State, Zip cea«•s ,.-MJ<--122-99108 _ Connection Charge(s) 270-00 — <br /> Owner (Mortgagor) *u covatmwtiza Total Fee_ 30-00 <br /> Spacial Utility iio;l knde <br /> t att <br /> Billing Name water I15.00IM17016 <br /> Never 303. <br /> Connection 1716.50 <br /> Connection By 418.00610 1120.00 <br /> Address 263m0210 _ Signed c Hrfu u nn <br /> p 11..11 <br /> E 1.901 $10.00 <br /> Phone I.48,W 120.00 <br /> DESCRIPTION: Sewer District <br /> —t.—_ Block NAl'kk 160.00 <br /> Lot <br /> Monthly Sewer Ser <br /> Plat SEVER 1301W <br /> Unplatted Description Monthly Sewer Cor>b 11 1Z70,00 <br /> 1171-5 1410.00 <br /> Trunk <br /> Type Permit: HeyCormact� <br /> Lateral <br /> Hemarks: Abutting Lot Line <br /> N, S, E, W ft. <br /> Approved By <br /> ny npmem <br /> IMPORTANTI Issued By <br /> CALL 1800-424.5555 48-HOURS <br /> PRIOR TO DIGGING <br /> CALL 2598811 FOR INSPECTION <br /> Inspection By— � <br /> Date Inspected <br /> SEE SKETCH ATTACHED No. 25973 <br /> INSPECTION <br />