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, everrtt <br />I �i <br />I� City of Everett <br />Sewer Application and Permit <br />No. 24275 <br />Service Address__ _ <br />Billing Address_ <br />City, State, Zip_ <br />Owner (Mortgagor). <br />Billing Name_ <br />Connection By_ <br />Phone <br />DESCRIPTION: <br />Lot <br />Plat <br />Unplatted Descripti <br />Tvpe Permit: <br />L <br />DATE <br />CHART N0. � � ' - <br />_ Utility Account No. <br />Permit Fee <br />Connection Charge� <br />Total Fee <br />� <br />Signed I <br />Customcr I <br />11:. <br />Sewer District - I <br />I <br />Monthly Sewer Service i <br />_ Monthly Sewer Constr. <br />— Trunk <br />Lateral I <br />Abutting Lot Line ' <br />N g, E; W ft. � <br />SEESKETCH ATTACHED <br />�r��;r��«ic�a <br />Approved B <br />Issued <br />City Engincer <br />Inspection By //�� � "�� �e'`� <br />.� � <br />Date l nspected �S "-!� ' �'-� <br />No. 24275 � <br />; <br />