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161 <br />City of Everett <br />Sewer Application and Permit <br />NO. 2 635 DATE October 4, 19B3 <br />Service Address <br />2517 elet Place S.E. <br />17928 43rd Avenue tl.E. <br />Billing Address----- <br />-- <br />Arlington, Na. 99221 <br />City, State, Zip <br />-- <br />_— <br />Owner (Mortgagor) <br />Ren Uerq <br />Billing Name —__Same <br />_ <br />Connection By- <br />Phone 659-6847 <br />DESCRIPTION: <br />Lot 48 Block <br />Plat Valley View II <br />Unplatted Description <br />SEE SKETCH ATTACHED <br />CHART NO. -- <br />4- <br />Utility Account No. 76284-9 <br />Permit Fee 30.00 <br />Connection Charge(s)__ 270.00 <br />Total Fee 30.00 <br />Ordinance 722-80 <br />Area 2 339.00 <br />Signed <br />Customer <br />INSPECTION <br />Sewer District <br />Monthly Sewer Service_ <br />Monthly Sewer Constr. <br />Trunk <br />Lateral <br />4butting Lot Line <br />N, S, E, W <br />Bond II <br />6.50 <br />290.00 <br />A. R. Theal <br />Approved By <br />Gty Engineer <br />R. Bond <br />Issued By --- — <br />1 <br />Inspection By - <br />Date Inspected 14�7 <br />NO. 24635 <br />—j <br />