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everett <br />� <br />City of Everett <br />Sewer Application and Permit <br />No. 23287 <br />, <br />DATE % '"� �� <br />,, <br />p�„ �� <br />Service Address -���7 iI'L— /v/A �� <br />Billing <br />City, S <br />Owner <br />Billina <br />CHART N0. N�' S ZS—� <br />��� <br />l�`�?„7� <br />)"'" <br />Utility Account No. ��' ' � '� <br />Connection <br />it Fee ,3d <br />9� <br />_,`,�...� <br />ection Charge�s) <br />�..,, �O �% <br />Address Signed i � <br />Customer <br />Phone .,��� 3�+ <br />DESCRIPTION: Sewer District o?� l7�is-�i�� <br />Lot — lock <br />Plat �Ca�o �_ � <br />Manthly Sewer Service <br />Unplatted Description_ Monthly Sewer Constr��� �� 3�� <br />SEE SKETCH ATTACHED <br />INSPECTION <br />Trunk � vZ <br />Lateral J / �6 /� <br />Abutting Lot ne <br />W c?�.`Z� ft. <br />,, <br />Approved By � -� <br />Ciry Engineer <br />Issued Bv — <br />Inspection By `� wt.wC` ` _ <br />Date l nspected 7� G-// <br />No. 232�7 <br />