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everetl <br />e <br />City of Everett <br />Sewer iApplication and Permit <br />N0. 25200 <br />Service <br />DATE <br />510 75th Plac� S.N. <br />7/31/05 <br />826 8.8, Ewrctt M�11 May <br />Billing Address _ <br />City, State, Zip �'��tt, Na�hluqton 9820{ <br />Owner�Mortgagor) ��x Nillif.ltonw� <br />Billinn <br />Connection By _ <br />Phone 355-4192 <br />DESCflIPTION: <br />Lot 116 Block_ _ <br />Plat Veralan� Erteta■ <br />Unplatted Description <br />Tvue Permit: Nar (bnn�etim <br />Remarks� <br />CIIAhi '10.. ___ <br />_.�1c,,,, ,� �,�a.�F„�oi <br />d/22/P( �,•, <br />Utility Account N� _ <br />Permit Fee__30.00 <br />Connection Charge�s) »0.00 <br />Total Fee 30.00 <br />Signed_ <br />Cuticmnr <br />Sewer District .___�d II _ <br />Mon�hly Sewei Ser�lce <br />_ Monthly Sewer Constr. <br />— Trunk 200.0� <br />� Lateral _ <br />Auutting Lot Line <br />N, S, E, W tt. <br />SEESKETCH ATTACHED <br />INSPECTION <br />Approved By A. R. Thoal <br />Cnv Enpineer <br />E. lwnd <br />Issued By ___ _ <br />Inspection B�• <br />.�1I �� �" L : <br />i � <br />Datelnspected_ 1� ��� � <br />NO. 25ZOO <br />