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f'r n i <br />everett <br />e <br />City of Everett <br />Sewer Application and Permit <br />NO. 24560 DATE __tlunc--jr, 990.3 <br />Service Address-6W 4__Col <br />Billing Address <br />City, State, Zip <br />Owner (Mortgagor) Mlrhaal Wray <br />Billing Name_ tame <br />Connection ey e.eta <br />Address <br />Phone 259 5977 _ <br />DESCRIPTION: <br />Lot Block <br />-- <br />Plat <br />Unplatted Description <br />Tvoe Permit: <br />Utility Account No <br />Permit Fee__ <br />Connection Charoel <br />Total <br />Signed <br />Customer <br />Sewer District <br />Monthly Sewer Service <br />Monthly Sewer Constr. <br />Lateral <br />Abutting Lot Line <br />N, S, E, W. <br />Approved By <br />it gineer <br />Issued By T_IIianna <br />Inspection <br />)ate Inspe <br />SEE SKETCH ATTACHED R NO. 24560 <br />INSPECTION P,nmo�"— <br />I <br />.1 <br />IL <br />