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everetl <br />� <br />City of Everett <br />Sew+rer Applieation and Permit <br />rvn. 24763 <br />?� , <br />DP.TE �7L��� <br />i � <br />Service Address_�,�� b �"��� <br />Billing,�ddress � U / '"'u` �3 � <br />City, State, Zip_ ,'�/R - 02 D� <br />Uwner (Mortgago � ' ��� <br />. illing Name — <br />Connection <br />Phone as9 - oP�� <br />C!iART N0. <br />Utility Account No. <br />Per nit <br />Connection Charge(sl_ <br />da <br />To:al Fee <br />/ O '— <br />Signed <br />customer <br />DESSC'�RIP7 JN: Sewer Dis*.rict <br />Lot-' S � � lO �� — <br />� Monthly Sewer Service. <br />Pla[ , /�' .y� <br />Unplatted Descriptlo �'R%/�����"�"��� Monthly Sewer Constr. <br />SEE SKETCH ATTACHED <br />� <br />I�J;P[CTION <br />Latera <br />Abutting Lot Line <br />N, S, E, W <br />Approved By � l np`�'O <br />� c�,Y E�y�,e�� <br />Issued By�`�'"',,� <br />Inspection By �j�� "-' �`�/��^ <br />Date Inspected -'�"l`� "�r� <br />No. 2�763 <br />t. <br />� <br />. <br />', 9 <br />�: � <br />