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everett ,_ <br />e- <br />City of Everett <br />Sewer Appiication and Permit <br />No. 23575 <br />Service <br />DATE <br />6209 Lvergreen t?ay <br />4neieo <br />Minit Lube <br />Billi�ig Address_ <br />140 tPest 2100 South <br />City, State, Zip Salt I.ake City, 84115 <br />Minit Lube <br />Owner (Mortgagor) <br />Samc <br />Billing Name <br />���'��Y <br />Connection By E on , pe��on Const. <br />Address <br />382-5391 <br />Phone <br />DESCRIPT�ON: 3 <br />Lot_ BIoc6: <br />Plat II�w_rly Hills Div. R2 <br />Unplatted Description <br />'r��P Permit: xew Connection abd 1 Catch Dasii: <br />CHART N0. � � � � ✓S <br />Utility Account No. <br />Permit Fee 40.00 <br />Connection Charge(s). <br />40.00 <br />Total Fee <br />Signed <br />Customcr <br />Sewer District <br />Monthly Sewer Service ttetered <br />SEE SKETCH ATTACtIED <br />Monthly Sewer Constr. <br />Laterai <br />Abutting Lot Line <br />N, S, E, W. <br />ts. Harren <br />Approved By <br />Ciry Enginccr <br />P.. IIond <br />Issued By <br />� <br />/ �Inspection - <br />Date Inspected �'` � — <br />No. 2357� <br />� I INSPECTIGN <br />, _� <br />� <br />� <br />� <br />