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I <br />W <br />City of Everett <br />CHART <br />t GP/es SE.✓% To OEq.✓ <br />`ie .0-.:?-ex. <br />Sewer Application and Permit <br />NO. 25219 DATE _ nuguat � 5 <br />Service Address <br />Billing Address uS 713 B.E. EyWmtt Mall Way <br />rverett, wa. 98204 <br />City, State, Zip_ <br />Owner (Mortgagor).—�Onin atom Homes <br />Billing Name Same <br />Connection By - ----- <br />Address --- <br />353-6500 <br />Phone— <br />DESCRIPTION: <br />Lot _ t� Block <br />Plat Mountain view Div. 5 <br />Unplatted Description <br />Typ? Permit: new Oonnectlun <br />Remarks: <br />14, 198 <br />Utility Account No. _ _ <br />Permit Fee 30.00 <br />Connection Charge(s) 330.00 — -- <br />Total Fee_ 30.00 <br />0adlnanco 994-83 <br />800.00 <br />Signed <br />cusfomm <br />Sewer District Bond 112 <br />Monthly Sewer Service 6.50 <br />Monthly Sewer Constr. <br />330.00 <br />Trunk <br />Lateral <br />Abutting Lot Line <br />N,S,E,W. <br />— — A. R. Theal <br />-- Approved By <br />Cary E.gmm <br />E. Bond <br />Issued By--- <br />SEE SKETCH ATTACHED <br />INSPECTION <br />Inspection By — <br />Date Inspected — <br />No. 25219 <br />z <br />0 <br />M <br />