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CHART NO. <br />everetl <br />� sf� ?n CNrlRT.w!- <br />"' <br />City of Everett <br />nr in qqoo .. vi s�yy <br />Sewer Application and Perr► 40 <br />W1W 11®W1$:. <br />2608s� <br />NO. DATE __M_4xst>-Lst � - <br />Service Address BE --_- Utility Account No. <br />Billing Address _y_n. lanx_492 Permit Fee 30.00 <br />City, State, Zip--&4"-s*eva.s wh gaoso Connection Charge(s)_ 270.00 _ <br />Owner (Mortgagor)_-�Wjtra L_T"v <br />Total Fee 30.00 <br />Special Utility Pee, Ord. 1171-85 <br />Billing Name 111111*11of 179.00 water <br />471.00 sewer <br />Connection By 650.00 <br />Address_ --_ Signed__ <br />Customer <br />Phone 6530as — <br />DESCRIPTION: Sewer District aTn1 IT <br />Lot Block <br />Monthly Sewer Service_ <br />Plat - N &by place _ <br />Unplatted Description Monthly Sewer Constr. <br />Trunk <br />Type Permit: Now Connection <br />Lateral <br />Remarks: <br />Abutting Lot Line <br />N, S, E, W - ft. <br />Approved By it-rrnsn Q_ mrrAl. <br />City Enp-neer <br />IMPORTANT! <br />Issued By MarVuat E. ':clsoe— <br />CALL 1-800424.5555 48 HOURS <br />PRIOR TO DIGGING <br />CALL 259-8811 FOR INSPECTION <br />Inspection By <br />--- - - - - - - --- - Date Inspected 4-17 q 11347 <br />SEE SKETCH ATTACHED No. 26086 <br />INSPECTION <br />