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CHART <br />evereit <br />e <br />City of Everett <br />Seyver Application and Permit <br />!l- ��-zs�— <br />NO. 23410 DATE � - �� �� �� I <br />-; ,� � � Utility Account No. � �_' ' `��-----" <br />Service Address ' '% <br />'�� / Permit Fee �b <br />n / - ' � ; .'� --'--�.-- <br />Billing Address , �' � <br />� Connection Chargels) ���'�� �/ <br />•, � <br />City, State, Zip=.----- / � � i/.� �--- <br />' � Total Fee <br />pwner (Mortgagorl �-------==--- <br />J <br />Billing Name - <br />Connection <br />, � <br />$I(J�Cd . Customer - � <br />I,, i% .- ._ - i <br />Phone � � -� <br />Sewer District <br />DESCRIPTION: � �' <br />Lot Block Monthly Sewer Service � - <br />Plat ;. y. �./ pllonthly Sewer Constr. <br />Unplatted Description.T= <br />;�, :y ii f �' <br />Trunk <br />SEE SKETCH ATTACHED <br />Lateral � � � ' �' � '� <br />>butting Lot Line <br />N S(,E,; W / � ft. <br />4ppfOV@(i By �/�Ciry�En9ineer f/ <br />� <br />Issued By " — <br />INSPECTION <br />Inspection E3y `�"� � <br />Date I nspected r � � � `� � <br />No. 23410 ; ' <br />