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CHART NO. <br /> WePoSte9 11-By -S0 <br /> City of Everett —DA <br /> Sewer Application and Permit v <br /> No. 23779 — <br /> DATE OCT__1ir_ 1980 <br /> Service Address 119 79th PL, s-�7_ Utility AL,:ount No. <br /> 71;011f r <br /> Billing Address <br /> 8614 53rd P1 W Permit Fee '+n- nn <br /> City, State, Zip Lunn SIA "2DA Connection Charges) <br /> 107 ro <br /> Owner (Mortgagor)._TUjDI� UATirpii CONaTo Total Fee <br /> Billing Name SAMH _ oRn. 669-80 ARRA 1 <br /> 221.00 <br /> Connection By <br /> SAME. <br /> Address 8614 53rd P1. w Signed cugomer <br /> Phone 355-0423 — <br /> Sewer District 6 DOND I <br /> DESCRIPTION: <br /> Lot 3 Blocr._ ---- Monthly Sewer Service 5.10 <br /> Plat EVRRGREi-Ii_ RTD:a: <br /> Unplatted Description Monthly Sewer Constr. <br /> Trunk 0.20 <br /> Type Permit: txW C0j=CMj Lateral <br /> Remarks: Abutting Lot Line <br /> N S E W ft. <br /> AIt . NARRNN <br /> Approved By <br /> City Engineer <br /> Issued By L cALrAeAx <br /> Inspectiorlls/ r� <br /> Date Inspected �—�✓ �� <br /> NO. 23779 <br /> SEE SKETCH ATTACHED <br /> INSPECTION <br />