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everen <br />e <br />City of�Everett <br />Sewer A�pplication and P�rr,-rit <br />No. 24159 <br />Service Address � � . <br />Billing Address <br />City, State, Zip� <br />Owner (Mortgagor) <br />� . <br />Billing Name _ <br />Connectio� By <br />DATE <br />Phone <br />DESCRIPTION: <br />Lot � Block — <br />Plat <br />�. , a -t . <br />Unplatted Description <br />Type Permit: ,� ����� <br />HemarKs: <br />� os-c� a <br />y-ZZ - g Z- <br />Utility Acc�unt No. <br />Permit Fee � <br />Connection Charge( <br />Total <br />Signed <br />Cus�omer <br />SEE SKETCH ATTACHED <br />INSPECTI01� <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 />City En9inecr <br />Issued By � _�� �� <br />Inspection <br />Datelnsoe <br />o� 24159 <br />