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everett <br />� <br />.. <br />City of Everett <br />Sewer Applicateon a�sd Permit <br />No. 2313� DATE �� d <br />� <br />CHART NO. Q ��3 �Z$ � � <br />���� <br />Service Address�� �' Utility Account N <br />Billing Address G Permit Fee <br />City, State, Zip_ <br />Owner (Mor;gagor) <br />Billing Name_ <br />Connection By_ <br />Phone <br />DESCRIPTION: <br />Lot3d� <br />Plat _�'�+-/"e ,�. <br />Unplatted Descripti <br />Type Permit: <br />f:I <br />Connection Charge� <br />Total <br />Signed <br />SEE SKETCH ATTACHED <br />INSPECTION <br />�,— (�'�� <br />� <br />;` <br />1 <br />Sewer District I <br />Monthly Sewer Service <br />Monthly Sewer Constr. <br />Lat��ral <br />Abutting Lot Line <br />N, S, E, W ft. <br />Approved By <br />City Enginecr <br />I ssu ed <br />Inspection By ��- <br />Date I nspected � � �� � � �. <br />rvo. 23138 <br />