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F <br />rett <br />Le <br />City of Everett <br />Sewer Application and Permit <br />No. 23991 <br />DATE �r <br />Service Address 315ilaA <br />Billing Address 6C712 13F RL1/ <br />City, State, Zip.E: r'TT USA '2F20 3 <br />Owner IMortgagor) a„N1q S1:Ai2Lrr4— <br />Billing Name JT) Ml/ ST/I/)I 4 <br />Phone 34-�; ,-44g'6 <br />CHART NO. 11 -7 - 28-5 <br />.5--21-8If <br />Utility Account No. r <br />Permit Fee <br />Connection Charge(q) 1 <br />1 O OO <br />Signed <br />Customer <br />DESCRIPTION: newer uisuicr <br />Lot Block Monthly Sewer Service, <br />Plat <br />Unplatted Description Monthly Sewer Constr. <br />Abutting Lot Line <br />N, S, E, W <br />Approved By ' <br />City Engineer r <br />SEE SKETCH ATTACHED <br />