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everetl <br />e <br />City of Evarett <br />Sewer Appika <br />No. 25805 <br />ServiceAddress— _C76 t+, <br />�O .�I H <br />ticn O'ncfQrrt <br />L h2mw <br />DARrE yst-iaFi;j"6 <br />Billi; n Address_eeg4 MroPIL FIE— <br />City, State, Zip --- 4%ry9v41itWA 98270 <br />Owner (Mortgagorl_.��.�_ <br />Billing Name <br />Connection By <br />Phone -M"-j1 <br />DESCRIPTION: <br />Loth_ Block <br />Plat —ilard Addis Addn <br />Unplatted Description_ <br />Permit: <br />Remarks: <br />IMPORTANTI <br />CALL 1-800-424555548-HOURS <br />PRIOR TO DIGGING <br />CALL 259 C811 FOR INSPECTION <br />CHART <br />SEvr 7c Cy/l,�Tiab <br />N <br />Utility Account No. <br />Permit Fee <br />Connection Chargelsl_ 110.00 <br />Total Fee10MO___ <br />Ord. 1171-RS - nail at time of plat <br />recor4ing <br />Signed <br />c usmn <br />Sewer District R <br />Monthly Sewer Service. <br />_ Monthly Sewer Constr. <br />Trunk 110.00 <br />Lateta <br />Abutting Lot Line <br />N, S, E, W_ It. <br />Approved By---" <br />inen <br />Issued Bye <br />ue cran7taw- <br />InspectionBy� <br />Date Insnected_ i=1G'f 6 <br />SEE SKETCH ATTACHED No. 258U5 <br />INSPECTION <br />