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everett <br />e <br />City of Everett <br />CHART NO. D— �' �L'^'" � <br />i\�'-1l � <br />���-,�, <br />Sewer Application and Pernnit <br />No. 23143 DATE �� % _ <br />, ,.� <br />Service Address S 2� � �'� Utibty Account I1o. <br />Billing Address_— Permit Fee <br />City, State, Zip Connection Charge( <br />Owner (Mortgagor) Total Fee <br />9illing Name <br />Connection Bv __ <br />DFSCRIPTION: <br />Lot � Block � <br />Flat <br />Unplatted Description <br />' Type Permit: <br />SEE SKEI"CH ATTACHED <br />IW:;�^EC11�,;� <br />Sewer District�a+-� _ <br />Monthly5ewerService — <br />Monthly Sewer Constr. <br />Trunk <br />Lateral <br />Abutting Lot Line <br />N, S, E, W. <br />Approved By __ _ <br />Citti Lng�i�v,�i <br />Issued <br />Inspection By <br />Date Inspected_ _ _ <br />N�� 23143 <br />