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Een 9(tab9 <br />City of Everett <br />Sewer Application and Permit <br />NO. 23110 DATE =4 <br />Service Address Ci U' / Utility Account <br />—c -- <br />Billing Address_ <br />City, State, Zip_ <br />Owner (Mortgagor) <br />Billing Name_ <br />Connection Bye <br />Address <br />Phone_ <br />DESCRIPTION: <br />Lot — <br />Plat <br />Unplatted Descripti <br />Tyne PErmit: <br />Permit <br />^ CHART NOY <br />99 <br />1�12 <br />1 j<1 <br />Connection Charge(s) <br />Total Fee I t <br />Signed <br />Customer <br />Sewer District f r ( 1-�- <br />Block— Monthly Sewer Service f`'tt= <br />SEE SKETCH ATTACHED <br />INSPECTION <br />Monthly Sewer Constr. <br />Trunk -2 G �, <br />Lateral I ' <br />Abutting Lot Line <br />N, S, E,�W G <br />Approved By <br />Giy Engineer <br />Issued By �- ( _..-/ , ( . <br />Inspection By 60 L <br />Date Inspected_ 1' z 4 7 <br />No. 23110 <br />