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evereH - <br />e <br />City of Everett <br />Sewer Application and Permit <br />N�• ��voJ2 Gn 1 <br />Service <br />Billing, <br />City, S� <br />Owner <br />Billing <br />Connec <br />DATE � � � - �� <br />Phone � ���?Q�� <br />DESCRIPTION: <br />Lot ,��-,� <br />Unplatted <br />CHART N0. �i 3U-2�1 -S <br />�as�ED 5- 2q -&� <br />Utility Account No. <br />QQ = <br />Permit Fee �� � <br />Connection Chargels) <br />Total Fee�c' <br />�� <br />Signed <br />Cusiomer <br />Sewer <br />Monthly Sew�.r <br />Monthly Sewer Constr <br />SEE SKETCH ATTACHED <br />INSPECTiON <br />Abutting Lot Line <br />N, S, E, W. <br />� � <br />Approved By�� �f� <br />—�y Engineer <br />Issued By � ( '�� � <br />Inspection By—����`-'-- <br />Date I nspected 1�o M RY �� go <br />No. 23605 <br />