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. <br /> I <br /> 4 <br /> 1 <br /> i <br /> �'�IO�VAN $62C7S �'3 CHARTNO_ . <br /> everetl <br /> U Z`f 2�-S <br /> e T Q�1 <br />� City oi Everett � S 1 C�►� �9'CN <br /> Sewer Application and Permit '� <br />� N�• G3158 DATE ,� I ' <br /> Service Address ' ` � Utility Account No. <br />� biiling Address � Permit Fee � _ <br />� City,State, Zip '. �. ' i Connection Chargels) <br /> i <br />� Owner (Mortgagor) �� � . .��. �• � . . , . Total Fee <br /> I . � , � <br /> Billing Name � � . � . _ <br />� Connection By + � <br /> f Ac!dress � - � � � Signed <br /> i Customer <br />� I PhOne r � � . <br /> DESCRIPTION: Sewer District � � . <br />� Lot , 'i � � �Block � '� _ <br />� Plat � � < <�.., � - /� ,_., Monthly Sewer Service � <br />' linpletted Descri;.tion_ Monthly Sewer Constr. <br /> Trunk <br /> Type Permit: I--I� � ,, , <br /> Lateral <br /> Remarks: <br /> Abutting Lot Line <br /> N, 5, E, W ft. <br /> � <br /> — Appraved By � ' <br /> i ' c��v e�o��em�. <br /> n <br /> � <br /> . Issued By_ '�. _ .r _ <br /> Inspectian By <br /> Datelnspected <br /> SEE �KETCH ATTACHED No. 23158 <br /> INSF'°CTION i <br />