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gver.eq <br />e <br />City of Everett <br />v� 9(�,f'� 9 cN � no.��`�� <br />��,�d <br />Sewer Application dnd P�rmit <br />No.23275 DATE L <br />Service Address �(,�!(�r/�/�(�+� �— Utility Accaunt N <br />Billing Address_ <br />City, State, Zip <br />Owner (Mortgagor) <br />Billing Nam <br />Connection <br />Address_ <br />Phone_ <br />�1/Zv 1 � � <br />��'�� �I �� <br />Permit Fee /`�w..Q P/ . <br />Connection Charge(s)_ <br />Total <br />Signed_ <br />Cusiamer <br />DESCRIPTION: Sewer District <br />Lot B locl <br />Plat Monthly Sewer Service <br />Unplatted Desr.ription Monthly Sewer Constr. <br />Type Permit: <br />SEE SKETCH ATTACHED <br />INSPECTION <br />Trunk <br />Lateral <br />Abutting Lot Line <br />N, S, E, W <br />Approved B <br />I ssu ed <br />Inspection By � <br />Date Inspected �f ' 2 `� �%9 <br />No. 23275 <br />