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H <br />9 �3co <br />rx <br />H Y� <br />H <br />�3 0 <br />0 x0 <br />to H <br />O� <br />O H <br />n . nnj, <br />r Hy <br />gto <br />H <br />0 o to <br />t 7 ttv <br />2 '-3 to <br />H 0 cn <br />ki <br />City of Everett <br />CHART N <br />TO POST III 6 'n�. <br />Sewer Application and Permit <br />ND. 26515 DATE s.nu+� 25 19a8 _ <br />Service Address ^"' 23rd str' --- <br />Billing Address » n box S9 <br />City, State, Zip * tti �� rJ oaeaa <br />Owner (Mortgagor) <br />Billing Name <br />Connection By ---- <br />Address z-�— — — <br />Phone ----- <br />DESCRIPTION: <br />Lot 2 Block— 31-- <br />Plat ea.. <br />Unplatted Description <br />Type Permit: <br />Remarks: <br />IMPORTANTI <br />CALL 1.800.424.5556 48-HOURS <br />PRIOR TO DIGGING <br />CALL 259-8811 FOR INSPECTION <br />SEE SKETCH ATTACHED <br />Utility Account No <br />Permit Fee <br />Connection Charge(s)_gg4J <br />Total Fee <br />Spacial Utility Poe Ord. 1171-DR <br />water 179.00 <br />sewer 471.00 <br />650.00 <br />__ Signed _ <br />Curtomn <br />Sewer District e. t TT <br />Monthly Sewer <br />Monthly Sewer Constr. <br />Trunk *70 Go <br />Lateral eRn on <br />Abutting Lot Lin&/�/M 101511VI 00(A114019 tttt <br />N S E W ft. <br />M1 M-, ()6 <br />141TEP t6MAX) <br />IN700 -515 <br />bL61ER 130.00 <br />Approved By J1' "...W*---- <br />WW'Iy442 <br />Issued By t <br />1411%, t20.00 <br />11ILU' t24H1.00 , <br />Inspection By <br />Date Inspected <br />No. 2!� <br />6515 <br />INSPECTION <br />a <br />