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everen <br />� <br />Ciry of Everett <br />Engineering & Community Services <br />Se�ver �►pplicction c�nd Permit <br />No. 22154 DATE _� � '�i' ' <br />ServiceAddress •` %� �j �'' f � <br />n� <br />Billing Address '� <� � � x /�� S <br />CitY,State,Zip �� ✓�-�.:.''— ,.,.3-� /1 �; . -�G <br />;� _ <br />Utility Account No. <br />r, <br />Permit <br />Connection Charge(s) _ <br />Owner (Mortgagor) %, i i r-� � :'� t� � ''. — � <br />��- � /i '"�f✓r�6t�FFee <br />BillingName � -��"� <br />Connection By �/�1;=.'",=" _ ! ' �� = ' <br />Address r�i i.'.� r / Z r; <br />Phone <br />DESCRIPTION: <br />Let 'f �'/v <br />Plat �' ��� �'n• <br />Unplatted Desc!iption. <br />Type Permit: <br />— ?- � '3- '1' <br />Block y�f� � <br />:' F <br />�;� � <br />Signed� �•l�"�� <br />� Cui[Ort12r <br />SEESKETCH ATT�CHED <br />�y�, iyl _q�� �, � ',i.�' ,f��'�.(k tr'.�"lri .f � tiy�s _e', � <br />�f; 1�;.d i. i.._��..-'..R . � ..Y : :i.. <br />Setiver Districi <br />�9onthly Sewer Service <br />Monthly Sewer Constr. <br />Trunk <br />Lateral <br />Abutting Lot Line <br />N, 5, E, W_ <br />Approved By '�' �'`�•�-. a-n,aj <br />ciry Enginecr �• — <br />�' /� ' �"' . <br />Issued By �` �i .!%%'�'�� <br />� _ <br />Inspection <br />)ate Inspected <br />• � <br />' w "1���rr�t�.y�`���� yjt .� + A�`. c ' ;,.� <br />