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everett <br />� <br />City of Everett <br />Sewer Application and Permit <br />CHART NO. <br />� s�o <br />1/-��� <br />N0. 23288 DATE ;L, / � = �% I <br />� n �i ,�/ <br />Service Address �.S n2 '�% i�i U:ility Account No. � y7 �� <br />,Qi D� - <br />Billing Address �� � Permit Fee ro�)�' <br />City, State, 2ip o Connection Charge�s) � 3��9 �� <br />� v� <br />Owner (Mortgagor) �al Fr� �J <br />Billing Name -� % <br />Connection Bv A�-,�.� ._. _ <br />Signed- / <br />Customer <br />Phone �.� � f/��,'�� <br />DESCRIPTION: <br />Lot —" ock <br />Plat <br />Unpiatted Description <br />SEE SKETCH ATTACHED <br />INSPECTION <br />Sewer District.— .;� 9 /�i�,� ,�� <br />Monthly Sewer Service <br />Monthly Sewer Constr. <br />Lateral <br />Abutting Lot Line <br />N, S, E, W <br />Approved By ' � �� <br />� Ciry Enpineer <br />Issued By % <br />Inspection By �7�^'� �a-`fi h <br />Date I nspected � I" G-79 <br />N0. Z��B� <br />