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Ldi <br />City of Everett <br />Engineering Department <br />Sewer Application and Permit <br />No. 21659 DATE i <br />Service Address 709 'j r'l(i2njd_i-, Utility Account <br />M1 <br />Billing Address 52 / -1- Connection Permit Fee �_/ n <br />City, State, Zip z � �, , (24 22,2:a Connection Fee <br />Owner (Mortgagor)S CZzo,&-c /7 e Total Fee <br />Billing Name Sn'W <br />Connection By/�_ <br />Address /1 % t y Sir/ - �lQrvr J�1 A Signed(er, y ' <br />Phone 5 2 -79k/S <br />DESCRIPTION: Sewer District A��Y fG1l/d <br />Lot L� / - / <br />Block Monthly Sewer Service �y, <br />_pr �� , � 4� 0 rr Monthly Sewer Constr. <br />Division or Addition � P ' <br />Type Permit: <br />Trunk <br />Lateral i <br />Abutting Lot Line <br />N, S, E, W. <br />Approved By � Sn i`�il > a <br />Ciry��nlp�ne�a j <br />Issued By Z <br />Inspection By /"'t d_2M _ <br />Date Inspected z:Z=/ <br />No. 21659 <br />