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r <br />11 <br />iF <br />11 <br />everett <br />I <br />e <br />City of Everett <br />Sewer Application and Permit <br />No. 24561 <br />DATE _ " _e" % " <br />7 _ <br />Ca C.¢ 7—�� <br />Service Address 0�''f / M� Utility Account No. <br />Billing Address "S I ULZr _ _Permit Fee <br />City, State, Zip i/ieii r i. �� �t :� "f'j Z Connection Charge(s) <br />Owner (Mortgagor) %/Gi.• �+ !A11 i,y-4— y Total Fee <br />Billing Name " ellC.r, r It - i L [. 7e- r- a' <br />Connection By_' <br />Address —L_ r.r nrL /l../t7V� Signed <br />Gj+ <br />Phone , _ 5ef-7) <br />DESCRIPTION: <br />Lot <br />Plat <br />Unplatted Descr <br />Block_ <br />Type Permit: ,tf , . <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 <br />Gty E-gmm <br />IssuedBv r16-L-r10+r+,CJ <br />nspection By ft—__ <br />)ate Inspecte <br />INSPECTION FOSt&j� <br />NO. 24561 <br />1 <br />nI <br />