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I <br /> CHART NO. <br /> everetl <br /> City of Everett <br /> T <br /> Sewer Application and Permit , <br /> No. 23941 DATE2*"a�-�1 <br /> Service Address <br /> 9 77th Placa S.N. Utility Account No. 75055-3 <br /> P.O. Ho= 419 Permit Fee 30.00 <br /> i <br /> Billing Address — <br /> Kirkland, Va. 98033 110.00 <br /> City, State, Zip Connection Charge(s) <br /> Owner (Mortgagor) <br /> Bherstad a Williams Total Fee 30.00 <br /> Same Ordinance 1669-80 <br /> Billing Name_ Area 1 221.00 <br /> Same <br /> .onnection By <br /> Address_ Signed <br /> Customer <br /> 827-049• <br /> Phone <br /> 6 Bond I <br /> DESCRIPTION: Sewer District <br /> Lot 14 Block Monthly Sewer Service 5.10 <br /> Plat Cedar Ridge !:states <br /> Unplatted Description Monthly Sewer Constr. <br /> Trunk 0.20 110.00 <br /> Type Permit: new Connection <br /> Lateral <br /> Remarks: Abutting Lot Line <br /> N S, E, W ft. <br /> A.R. Theal <br /> Approved By <br /> i City Engineer <br /> L. Bond <br /> Issued By <br /> Inspection By <br /> _ Date Inspected—.-6 n ly t'` F-)t l <br /> SEE SKETCH ATTACHED No. 23941 <br /> INSPECTION <br /> I <br />