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cverctt <br />City of Everett <br />CHART NO. <br />gsSggp $ �� <br />Sewer Application and Permit <br />NO. 27474 <br />DATE January 16, 1490_ <br />Service Address — <br />Billing Address_-- ------ <br />City, State, <br />Owner (Mortgagor)—Aayaww�i>.xwer --- <br />Billing Name <br />Connection --- <br />Phone <br />DESCRIPTION: <br />Lot Blor': <br />Plat <br />Unplatted Description_. <br />Type Permit: Alteration_ — <br />Remarks: <br />IMPORTANT] <br />CALL 1.800•124-555548-HOURS <br />PRIOR TO DIGGING <br />CALL 259A811 FOR INSPECTION <br />SEE SKETCH ATTACHED <br />Utility Account No. <br />Permit Fee 10.00 <br />Connection Charge(s) <br />Total Fee 10.00 <br />Signed Ca.ton' <br />Sewer District <br />Monthly Sewer Service <br />Monthly Sewer Constr. <br />Lateral <br />Abutting Lot Line <br />N, S, E, W <br />Approved By— ENDg' 2 hL — <br />CnyEnvnw <br />Issued By--__&uay nA oax <br />Inspection By — <br />Date I nspected_ <br />I I::':'I +'.ri ! Ui"l <br />No. 27474 <br />e <br />