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CHART <br />everett <br />e <br />City of Everett <br />Se�wer Application and Permit <br />No. 23485 DATE 2�5/80 <br />5830 IIa�t Drivn <br />Service Address Utility Account No. <br />Billing Address Permit Fee �� <br />City, State, Zip <br />Owner (Mortgagor) <br />Billing Name <br />Connection Bv City of Sverett <br />Phone <br />Connection Chargel <br />None <br />Total Fee <br />Signed flOn Ltillur <br />DESCRIPTION: Sewer Disirict <br />Lot Block <br />Plat Monthly Sewer Service <br />Unplatted Description Monthly Sewer Constr. <br />Type Permit: NF.W COlttaSCTIOtd <br />SEE SKETCH ATTACHED <br />INSP[C710N <br />Abutting Lot Line <br />N, S, E, W, <br />ti. t7ARRE17 <br />Approved By <br />Ciry En9incer <br />E. D02iD <br />Issued By <br />Inspection By --�i C/ %7l � , � � %%` <br />Date Inspected -�" � �% � `'%' <br />No. 23485 <br />