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evereq � �� <br />� �_ <br />City of Everett <br />Sewer Application and Permit <br />No. 24628 <br />Service <br />Billing <br />City, S' <br />Owner <br />Billing <br />DATE /r/' �/�3 <br />Connection <br />DESCRIPTION: <br />Lc —� �,•,— Block 3 <br />Plat ���'�""v � <br />Unplatted Description <br />.r" <br />CHART NO. v �D -z S - �' <br />Po� a-�_ - - -' - <br />Utility Account No. <br />�� <br />� Permit Fee �— <br />Connection Charge(s) <br />Total Fee �✓d <br />; / �._., � <br />' %.'`/;.'�,. .�(�- ' <br />Signed_ .• � - � .�� <br />,;;�+" Customer �•- <br />/. . <br />Sewer District / <br />Monthly Sewer <br />Monthly Sewer Constr. <br />SEE SKETCH ATTACHFD <br />INSPECTION <br />tting Lot Line <br />N, S, E, W. <br />roved By, ,� %r��� <br />� n8ineer <br />�d BY�� <br />ection By <br />�- � ���� <br />I nspected �n '� y' O^� <br />rvo. 24f28 <br />_� <br />� <br />i <br />1 <br />J <br />