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evere� <br />� <br />Cir.� of Everett <br />S�Wer qpplication aG�d Permit <br />No. 237is <br />Service <br />Billing � <br />Clty, $1 <br />Owner <br />DATE <br />Billing Name <br />Connection <br />i <br />r <br />Address <br />Phone <br />� `i �% '� r��-�-- <br />DESCRIPTION: ���b <br />Lot ��=-- Block�— <br />Plat rt <br />Unplatted Description <br />Utility Account <br />Permit <br />� LC _ <br />CHART NO• N � " { ' <br />� <br />Con��ection Chargels) <br />J ; <br />, °i � <br />Total Fee_�1--- <br />Signed Ci�smmer <br />Sewer District - <br />Mon:hly Sewer Service_ <br />_ Monthly Sewer Constr. <br />— Trunk <br />La[eral <br />>butting Lot Line <br />N, S, E, W <br />SEE SKETCH ATTACHED <br />�i . � <br />:� . ��a,��� - <br />; � <br />Approved By -- '".—"` <br />City Engineer <br />/f /C, / <br />Issued By , ��'��� ,' <br />INSP[CTION <br />Inspection B ` — <br />_ �. <br />Date I nspected � � �� — <br />No. 23716 <br />