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everett <br />�`�� <br />Ciiy of Everett <br />En9ineering & Community Services <br />������ �p��������� ��a� �'e�a�a�� <br />CHAHT NO. ` <br />������_� � <br />J }- s=. - <br />�v5 r`�{°'v�i. �: <br />9�� _ <br />,_ �. <br />,.� ���/ ;' . _ � cc� - � <br />9 � l ie+>7 �'Y --�' <br />� r � <br />_. .� _ _ : <br />�Ii_ " ' /�. c-,+ _ - - - ". <br />� �. <br />No. �2264 DATE 3 � /T L <br />Service Address 7� ��� ,��-�'�-��" r�/�; ��:ility Account N <br />Billing Address — <br />City, State, Zip <br />O�vner (Mortg�gor) <br />Billirg Pd3me <br />� <br />Connection By._ > G j' `� � <br />Address --- � — <br />Phone <br />DESCRIPTION: <br />Lot <br />Plat <br />Unplatred Descripti <br />Biock <br />Permit Fee �7^ -^-�-y <br />Connec[ion <br />Total Fee____� � ,. -_—�� <br />Signed�'�-., -�-+L,r—.'—J.�-G� <br />Cus;omnr <br />Sewer District__ <br />Monthly Se�Ner Service. <br />Mon[hly Sewer Cons[r. <br />Tru n k___ <br />Lateral__ <br />Abutting Lot Li�e <br />N, S, E, W_ <br />SFE SICETCH ATTACHED <br />Appro�(etl'B���r �'=-f �-�" <br />(� CrtyEn9ine?r � <br />Issued By �u �� --��''�`' <br />Inspection B}. L''�-� -� ��}'0-'�� �-�.� <br />� <br />Datelnspec[ad j -- � � <br />NO. ����j� <br />CUSTOP,tER COPY <br />