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everett <br />e <br />City of Everett <br />Sewer Application and Permit <br />CHART NO. <br />SE.vT To !//927i41& /0/4/8 6 <br />No. 25661 DATE No* .�iy86 L <br />Service Address 22e _ gird fi M Utility Account No <br />Billing Address 1429 RMNA -V <br />City, State, Zip is ftMRt& _Im oAsel <br />Owner (Mortgagor) 2a-- -&str <br />Billing Name -- - Ilet3a lt_y <br />Connection By_�t� eollEriz. <br />Permit Fee —a0 DO <br />Connection Chargelsl_ °30 00 <br />Total Fee M DO <br />06/02f% 2116PH 00WA J21 n# <br />Address--_a29 ern.as.v srran.et, taa <br />sa2o1 Signed <br />M M16166 <br />c <br />11D <br />Phone_ 252—i1BR <br />U 11111 <br />$1.50 <br />141111 <br />$242.50 <br />DESCRIPTION: <br />Sewer District <br />PIA13 <br />f20.00 <br />Lot_tg — Block_ <br />Monthly Sewer Sert <br />4-0.00 <br />Plat <br />Unplatted Description <br />Monthly Sewer Con ER <br />t O�0O0 <br />Type Permit: <br />Trunk <br />1171-5 <br />IJILIX <br />1130.00 <br />Lateral <br />_. <br />Remarks: <br />Abutting Lot Line <br />N,S,E,W <br />Approved By <br />IMPORTANTI <br />CALL 1.88p-024-6555 48-HOURS Issued By <br />PRIOR TO DIGGING <br />CALL 259-8811 FOR INSPECTION _ <br />Inspection By <br />Date I nspected !'- Y-jr-6 <br />SEE SKETCH ATTACHED No. 25e61 <br />INSPECTION <br />