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everett <br />e <br />City of Everett <br />Sewer Applicution and Permit <br />CHART NO. <br />SE.J7 To C//uori.✓O /]/3o/66 <br />No. 25691 DATE Apr4t 11e 1a86 L <br />Service Address 024 - 90th Pl SP. _ Utility Account No. <br />Billing Address 713ZE ZVa=tt u.lt way <br />City, State, Zip---Lvsratt, R 982P4 <br />Owner (Mortgagor) r'�tn cit• t.. , <br />Permit Fee 30.00 <br />Connection Charge(s)_ 11+0.e0 <br />Total Fee 30_00 <br />Billing Namc ea„r, Special Fees, Ordinance 1171-851 <br />Water 179.00 <br />Connection By Sever 471.00 <br />650.00 <br />Address _ Signed <br />Cutl mer <br />Phone—353-6500 — <br />DESCRIPTION: <br />Lot— Block <br />Plat wm.tairrview is <br />Unplatted Descrption <br />Typo Permit: <br />Remarks: <br />IMPORTANTI <br />CALL 1.800.424-555548-HOURS <br />PRIOR TO DIGGING <br />CALL 259-8811 FOR INSPECTION <br />SEE SKETCH ATTACHED <br />Sewer District V�A =I* <br />Monthly Sewer <br />Monthly Sewer Constr. <br />Tru <br />Abutting Lot Line <br />N,S,E,IN <br />Approved By )►EBBED R THEAL — <br />Ciry Engineer <br />Issued By tltazaarat 9 mclaw <br />Inspection By <br />Date I nspected dNo. 25621 <br />INSPECTION <br />