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everettt d 0 <br />City of Everett <br />--1o100'0ZL9� <br />Sewer Application and Permit <br />No. 23744 DATE <br />9/10/80 <br />6515 51th Avenue West <br />Service Address <br />855 106th Avenue N.E <br />Billing Address <br />Bellevue, We. 98009 <br />City, State, Zip <br />Owner (Mortgagor) <br />821 Associates <br />821 Associates <br />Billing Name <br />Same <br />Connection By <br />Address <br />453-5a54 <br />DESCRIPTION: <br />Lots-- Block <br />Plat 13 29-4 <br />Unplatted Description <br />SEE SKETCH ATTACHED <br />CHART NO. C 1?r;28-4 <br />CALL 48 HOURS <br />BEFORE YOU DIG <br />1-800-562-6478 <br />14781-9 <br />Utility Account No. <br />Permit Fee 390.00 <br />5,323.63 <br />Connection Charge(s) <br />390.00 <br />Total Fee <br />Ordinance # 669-80 36,720.00 <br />South end Interceptor <br />SignerFheck #060370 <br />Customer <br />16 Bond III <br />Sewer District <br />Metered <br />Monthly Sewer Service___---- <br />Monthly Sewer Constr. <br />XXXM XgpXO )M 39.63 <br />Trunk <br />Lateral <br />abutting Lot Line 1321 <br />N,S,E.W <br />4pproved BY— B. Warren <br />c�tr engineer <br />E. Bond <br />Issued By_------ <br />'535 $390.00 TOTS -- <br />Inspection By CI -PT <br />.�:, <br />Date Inspected ......., , ., <br />No. 23744 <br />1 0 SIP .8 0 <br />CUSTOMER COPY <br />