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ev��rett <br />� <br />Gity of Everett <br />Sewer Applicat�on and Permit <br />N0. ��9Z6 DATE �� � a igpa <br />Service Address�.� . <br />8illing Address . <br />City, State, Zip <br />Owner (Mortgagor) , A <br />Billing Name � <br />Cannection By�— <br />Phone aa� 3279 <br />DESCRIPTION: <br />Lot �-- Block <br />Plat :�� Pi ryyyh <br />Unpla:ted Description <br />Permit: <br />Remarks: <br />IMPORTANTI <br />CALL 7-800�424�555648�Ii0URS <br />PRIOR TO DIGGING <br />CALL 259�8811 FOR INSPECTION <br />SEE SKETCH ATTACHED <br />Utility Account No. <br />Permit Fee �� ^� <br />Connection Chargels) »� �^ <br />Total Fee <br />btility Devalopnent F�e Ozd. 1171-BS <br />wter 179.00 <br />■�er e�i.oe <br />u50.00 <br />�I �r•i:i�o 1:4('ry (q1�k''.H"::76 i:kt <br />Signed c�:m�„« <br />iifrl0. b"'_o <br />'J_IA.I' '. +1!.110 <br />Sewer District ����� i � i7:1i.(p <br />� -.� . ,_ . <br />Monthly Sewer Serv���'�1fi5� - <br />) j4,1�.1 <br />_ Monthly SewPr Con4ir�' ����'"� <br />i�.l'H ::'.£3.C1� <br />�i 11 4110.k1i <br />— Trunh ��k . �— <br />�• <br />� Lateral��4�1�� ltS;LU _ <br />!I[kH 41S I 14 <br />� Abutting Lot Line�.i��h yb`30-1rt1 <br />N, 5, E, W ft. <br />Approved Sy ".^..�-- <br />�iv npin�er <br />Issued By — <br />Inspection <br />Date I <br />If�:�PGC i iOiJ <br />No. 26926 <br />