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CHART NO. <br />evered <br />e <br />City of Everett <br />Sewer Application and Permit <br />No. 25147 DATE -- <br />Service Address ©-Q B9th-Street S.E.-____ Utility Account No. _ <br />Billing Address�l--&.L• <br />City, State, Zip Eve.rettr Naehington 98204 <br />Owner (Mortgagor) ----- <br />Billing Name_ <br />Connection By -- <br />Address — <br />Phone aaa_Rtne — — — <br />DESCRIPTION: <br />Lot— 12-- Block--- <br />Plat <br />Unplatted Description <br />Type Permit: JIM CkOrAK"0111 _. <br />Remarks: <br />SEE SKETCH ATTACHED <br />Permit Fee 30.00 -- <br />Connection Charges) 330.00 <br />Total Fee 30.00 <br />ordinance 984-83 <br />800.00 <br />Signed cui� mrr <br />INSPECTION <br />noad III <br />Sewer D <br />Monthly Sewer Service 6,50 <br />Monthly Sewer Constr. <br />Trunk _ 330.00 <br />Lateral — <br />Abutting Lot Line <br />N,S,E,IN <br />Approved By A. K. Theal <br />Ed, Engmeer <br />Issued By— $. )"— <br />--- <br />Inspection By v <br />Date Inspected l 3 <br />No. 25147 <br />