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! <br /> everett CHART N0. <br /> e � <br /> � . <br /> _ i � <br /> City of Everott �' <br /> � � � � � � � <br /> � y r� s 7 0 " <br /> • M� M N N ^y M <br /> Sewer Application and Perm�t, � `� ' � �g <br /> N 26868 � � � �� � � � �� � <br /> 0. DATE u..,r��... �n�'"�oaa <br /> Service Address U27 100tA� q� �-`�'� Utility Account No. <br /> Billing Address— � Permit Fee_ ie_en <br /> City,State, Zip Pwe�tt. tu 9g�0� _ Connection Charge�s) <br /> Owner (Mortgagor►_]Oar�ond Ea�ah Total Fee_ io_oo <br /> Billing Name- 8a.. <br /> Connection By <br /> Address <br /> _ Signed <br /> cu,romer <br /> Phone <br /> DESCRIPTION: Sewer District <br /> Lot y�� Block <br /> Plat_ laisrar S�t�t�i Monthly Sewer Service <br /> Unpletted Description Monthly Sewer Constr. <br /> Type Permit: Trunk <br /> Lateral <br /> Remarks: <br /> - Abutting Lot Line <br /> N, S, E, W ft. <br /> APProved By �r.�a�.. e_ iwar�r <br /> CitY Enqmeer � ""� I <br /> IMPORTANTI — I <br /> CALL 7�00�424•655548-HOURS issued By_w�.� a.nq�n <br /> PRIOq TO DIQOING I <br /> CALL 269A811 FOR INSPECTION <br /> Inspection By <br /> Datalnspected <br /> SEE SKETCH ATTACHEO NO. 26�68 <br /> IfJ:;PCCTION <br />