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everetl <br />e <br />City of Everett <br />Sewer Application and Permit <br />No. 23379 <br />�� <br />DATE _ � j�% � <br />Service Address .5 }7 �U �.et� oU.r`'' <br />BillingAddress 1��� o <br />� � <br />City, State, Zip � � aGs�l.�. ��� � <br />Owner (Mortgagor) �.L' ,,��L�l�-�� <br />Billing Name .��rs.�L <br />Connection <br />Aod <br />DESCRIPTIOPr. <br />Lot �_ <br />CHARTNO.m— �'—�t'�� <br />2 -zz -�6 <br />�� <br />Utility Account No. '— <br />� <br />Permit Fee �D <br />Connection Charge(s) '` <br />Total Fee 7 �� �N <br />Signed_ . r"!l i � <br />" �- Cus�omcr <br />r � <br />Sewer District��i.�-rz,.� �� <br />Plat � Monihly Sewer Service ��✓f' �-�'-,� <br />Unplatted Description�t/2 a 3 —��— ?9 Monthly Sewer Constr. <br />M l� - �s�-.s' <br />Type Permit: <br />SEESKETCH ATTACHED <br />INSP[CiION <br />�- <br />Abutting Lot Line <br />N, S, E, W. <br />Approved By!��. �f�r � c- <br />ciry nyinecr <br />Issued By �,• ,/�.G/�,-w>`'� <br />� <br />Inspection By ��/��-�-�---- <br />Date Inspected `'� �C� \! ( ��'7 � <br />No. 23379 <br />