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everen <br />e <br />City of Everett <br />Sewer Application <br />N0. 27676 DATE <br />CHART <br />�7 <br />8-�6-SI <br />888��8 88 <br />ar c!Yermi _ <br />14 sch 30 1990 <br />Service Address 815 - 84th St SE <br />Billing Address 19911 - Ar t per_ <br />City, State, Zip ttdamedy wA 9Snzn <br />Owner (Mortgagor) <br />Billing Name — <br />Connection By_ <br />Address <br />DESCRIPTION: <br />Lot_ Block -- <br />Plat <br />Unplatted Description <br />Type Permit: <br />Remarks: <br />IMPORTANTI <br />CALL 1-80OA24-5555 48-HOURS <br />PRIOR TO DIGGING <br />CALL 259.8811eFOR INSPECTION <br />SEE SKETCH ATTACHED <br />Utility Account No. <br />Permit Fee an on <br />Connection Charge(s) 72o nn <br />Total Fee <br />Ordinance nn-as <br />water 179.00 <br />sewer 471.00 <br />�� bS0.00 <br />Signed <br />— cue r <br />Sewer District Qcud =_ <br />Monthly Sewer <br />Monthly Sewer Constr. <br />Trunk 270 en <br />Lateral 4So Do <br />Abutting Lot Line <br />N, S, E, W <br />Approved By *>• r�eevrronn <br />City Enpmeer <br />Issued By _-J-Aaakwsl <br />Inspection ByT�� <br />Date Inspected <br />No. 27676 <br />INSPECTION <br />