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CHART NO. <br />everett <br />City of Everett <br />Sewer Application and Permit <br />NO. 26084 DATE JU11112=3ft March 5, 1907 L- <br />Service Address 1802 - 70gt Pi Sx _ Utility Account No. <br />Billing Address P.O. how 532— <br />City, State, Zip_-j,ake_fiteltknc. HA 90250 <br />Permit Fee 30.00 <br />Connection Charge(s)_ 270.00 <br />Owner (Mortgagorl_ Malum 6 SYaith Total Fee _ 30_00 <br />Billing Name. Same <br />Connection By Sane <br />Address <br />Phone__ <br />DESCRIPTION: <br />Lot = r. Block <br />Plat Selby F1 e- <br />Unplatted Description _ <br />Type Permit: Now Connection <br />Remarks <br />IMPORTANTI <br />CALL 1ZGOA24 5555 48 HOURS <br />PRIOR TO DIGGING <br />CALL 2598811 FOR INSPECTION <br />SEE SKETCH ATTACHED <br />Special Utility Pee, Ord. 1171-851 <br />water 179.00 <br />savor 471.00 <br />G50.00 <br />Signed <br />Customer <br />Sewer District_ Rend II -- <br />Monthly Sewer Service _ <br />Monthly Sewer Constr. <br />Trunk <br />Lateral <br />Abutting Lot Line <br />N, S, E, W <br />Approved By ar.oern n_ THrjkL <br />Crty Engmee, <br />Issued By margAr t. R_ wnTam <br />Inspection B _k <br />Date Inspected - <br />ND. 28084 <br />INSPECTION <br />