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everetl <br />� <br />City of Everett <br />Sewer Application and Permit <br />No. 25579 <br />r <br />Service Address_G <br />Billing Address_ <br />DATE <br />CitY, State, 2ip _ / % " { ' I <br />Owner (Mortgagor) � � <br />Billing <br />Connection <br />CFIART N0. <br />.�r�, �� ini'.-:.,��..- !/�V/;�? <br />Utility Account No. <br />C <br />Permit Fee_� '� <br />Connection Charge�s) <br />Total Fee__ _ <br />� y �� Sigrn�d_ <br />� � <br />DESCRIP�T,�,�Ny�� <br />lot�[_�_ Block <br />Plai <br />Unplatted Description_ __ <br />Type Permit <br />Remarks: <br />IMPORTANT! <br />CALL 1-800-024�555548�HOURS <br />PRIOR TO DIGGING <br />CALL 259�8811 FOR INSPECTION <br />SEE SKETCH ATTACHED <br />�.wer District <br />Monthly Sewer <br />_ Monthly Sewer Constr. <br />liSii7/6G IU�'�`�]A.1Mk1+MOGi)a IIt� <br />' Trunk <br />i��rr� �ro.i�u <br />Lateral N 5F•CI{ �1_5p <br />t !.I,Y:�I f15.fX1 <br />Abutting Lot Line����rl 5330,�1U <br />N S E W'�.IILF 13(I.lul _(t. <br />I7.DIi t245.�bi <br />tt[a; 12U,ie� <br />fV la! ?�i.'in. <br />ApprovedBy i1�1i, ;1i'�i4,�ii_ <br />cnv eoyioem <br />Issued 8y <br />Inspection By�— <br />Date I nspected �/ �� 2 ��D <br />No. 255 79 <br />