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everett <br />e <br />City of Everett <br />(ewer Application and Permit <br />No. 23476 DATE I ! ' ia CL <br />lr Utility Account No. <br />Service Address <br />Pormit Fee <br />Billing Address— _ �--� <br />Connection Charge(s) <br />City, State, Zip <br />Fee-- <br />owner (MortgagorYL i/L <br />"�c:�i_sy1�l�=Total <br />Billing Name C -� ,/4 ooLF L l C�Z <br />Connection By— _ <br />Signed <br />Phone —7 <br />DESCRIPTION <br />Lot Block <br />Plat <br />Unplatted Description <br />Type Permit_ <br />C <br />Remarks: <br />SEE SKETCH ATTACHED <br />Sewer District <br />Monthly Sewer Service. <br />Monthly Sewer Constr. <br />Trunk— <br />Lateral — <br />Abutting Lot Line <br />N. S, E, W— <br />Approved By � t� E�9�,,pef <br />Issued <br />INSPECTION <br />- <br />Impaction Bye---" <br />Date Inspected <br />No. 23476 <br />