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e�re <br />e� <br />City of Everett <br />w�y�,���s <br />Sewer Applicatior� and Permit <br />No. 23305 <br />� <br />DATE <br />% /�7i =� � <br />,—�, <br />� � <br />Service Address % ' "�� ' ' � �r <br />Billing Address �� <br />�` ��, ,. <br />City, State, Zip _ ���'- �i-�'����'� �� <br />���' . <br />Owner (Mortgagor) �� �< �-�-�; <br />Billing Name_ <br />Connection By_ <br />Address__ <br />Phone <br />DESr_.RIPTION: <br />Lot. <br />Plat <br />Unp <br />Tvoe Per <br />CHART NO. \ ' , ` � <br />�-� 3 _ � � _ �, <br />Utility Account No. <br />Permit Fee <br />Connection Chargel <br />Total Fee __ <br />Signed <br />���!�'� `- , <br />%�i -/�.. .� <br />, i <br />c <br />C.� i' <br />c'� � <br />Sewer DistricE�-1z�� � L 1����C� 3�� <br />Block <br />Monthly Sewer Service�-��-�� <br />SEESKETCH ATTACHED � <br />IrI�PE�: iiU�d <br />Monthly Sewer Constr. <br />Lateral <br />Abutting Lot Line <br />N, S, E, W <br />Approved By <br />c�iv e�,9��,«< <br />Issued B <br />Inspection By -%���`'ta�l'7 ✓�� �. <br />�ate I nspected 9- i 9-� r� <br />No. 23305 <br />