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everett <br />e <br />City of Everett <br />Sewer Application and Per�it <br />No. 23644 <br />Service <br />Billiny <br />City, S <br />Owner <br />BIIGny ivaiiic <br />i <br />Connection By - -f-.��� _ <br />GATE � - �+ j- �+'� _ <br />Phone_��"�- L(r � � <br />DESCRIPTION: <br />Lot_ �� Block ��� <br />Plat � � �� -= _ <br />Unplatted Description <br />CHART NO. F.� 2� '2C{ -S <br />P���,,� �_z,-� <br />� <br />Utility Account No. <br />_5�=- <br />Permit Fee �; . <br />Connection Charge(s) <br />Total Fee <br />ii f `-' - <br />� <br />Signed <br />Customcr <br />SEE SKETCH ATTACHED <br />INSPECTION <br />Sewer District <br />Monthly Sewer Service__ <br />Monthiy Sewer Constr. <br />Lateral <br />Abutting Lot Line <br />N, S, E, W <br />Approved By <br />City Engineer <br />�SSUI'd � <br />Inspe�tion BY ��' ��^/ � / ' — <br />__-��,- -- <br />Date Inspected_f % "CV�-`1 � <br />rvo. 23644 <br />it. <br />