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everetl <br />e <br />City of Everett <br />Sewer Application and Permit <br />NO. 24351 DATE ___ 9116/n; <br />Service Address 702 7th Street S.M. <br />Billing Address 026 S.E. Everett Mall May <br />City, State, Zip Everett, We. 95204 <br />Owner (Mortgagor) Hillis Hoses, Inc. <br />Billing Name Hillis Hoses, Inc. <br />Connection By Hillis,eoses, Inc. <br />Phone 355-4492 <br />DESCRIPTION: <br />Lot 148 Block <br />Plat Veralene Es¢ates <br />Unplatted Description _ <br />SEE SKETCH ATTACHED <br />CHART NO <br />Utility Account No._ <br />Permit Fee 30.00 <br />Connection Charge(s) <br />Total Fee 30.00 <br />761n9-0 <br />Signed <br />customer <br />INSPECTION <br />Sewer <br />270.00 <br />Bond II <br />Monthly Sewer Service_ 6.50 <br />Monthly Sewer Constr. <br />Trunk 1.15 270.00 <br />Lateral <br />Abutting Lot Line <br />N, S, E, W <br />Approved By A. R. Theal <br />ci'v Engineer <br />E. Bond <br />Issued By <br />Inspection By <br />Date Inspected V j4 — — <br />NO. 24351 <br />191 <br />