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�ART N0. � � y�z � �� <br /> everetl • <br /> e <br /> City oi Everett <br /> Sewer Application and Permit <br /> NO. 2295H DATE —,�// �- / — <br /> Service Address�_.� _-. �Utility Account No. - <br /> � <br /> Billing Address ' Permit Fee - <br /> City, State, Zip � � <br /> � Connection Chargelsl r-- <br /> Owner �Mortgagorl_-- <br /> .' Total Fee___ � <br /> - -- ------ <br /> Billing Name <br /> Connection By — • � / / <br /> . �' <br /> ; `. <br /> Signed. . . _. ----�----j_ -� ---�-�---� ---� <br /> Address — � ��•����^^�� <br /> . � ; ' <br /> Phone - --- — � ---- <br /> DESCRIPTI ON: <br /> Se�vci Disirict_ . ._-_ .__--- <br /> Lot_ Block Monthly Sewer Service__ - --- — <br /> Plat_ — <br /> Unplatted Description ' � �' � Monthly Sewer Constr. <br /> � <br /> ' Trunk_ _ _ __ ____._— <br /> Type Permit: <br /> Lateral <br /> Hemarks: Abuttiny Lnt Line <br /> N, ;, [, W_ _ --it. <br /> Approved By -- ------- <br /> cnv e��y�,���•� <br /> / <br /> __ IssuedBY _. _�_----- <br /> �j r <br /> Inspection �i•%=, - -�,--- <br /> � <br /> -- <br /> �------------- — — <br /> .___ Datelnspected_�~/ -- - <br /> SEE SKETCH ATTACHED NO. 22958 <br /> INSI'CCl IUN <br />