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everetl <br />e <br />City of Everett <br />CHART <br />Stn{, f� <br />c,��ar�-�, ,u <br />� i /�r: <br />�f � .. <br />Sewer Application and Permit <br />N0. 2�QJ�2 DATE <br />Service Address S/�) — 7y�� �� p 7 ,Sf Utility Account Na. 76157 <br />Billing Addres <br />City, State, Zi <br />826 S,E. L•ver�lt �tall Nay <br />Evez�ti. Na. 50401 <br />Owner (Mortgayor) Nlllis !1o►ais inc. <br />8illing <br />Connection <br />Phone 355-1492 <br />Permit Fee 30.00 <br />Connection Charge�s) =70.00 <br />Total Fee_ 3Q <br />Signed <br />custome, — -- <br />DESCRIPTION: Sewer Distiict <br />Lot 94____ Blocl: <br />Plat _Yfsal��e� £eLt1e Monthly Sewer Service <br />Unplatted Description Monthly Sewer Constr. <br />Tv..n Pn....l.• <br />SEESKETCH ATTACHED <br />INSP[CTION <br />7ru <br />Abutting Lot Line <br />N, 5, E, W, <br />Hond II <br />Approved By�.t <br />Ciry Enpineer <br />Issued L'y r' �`� <br />470.00 <br />1 <br />�� � <br />nspection By �'�� � ./ \ ✓`��_,- - <br />)ate Inspected��� � ���1 `-'' _ <br />rvo. 25052 <br />