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everett <br />e <br />Ciq of Everott <br />Sewer Application and Permit <br />No.24125 DATE i:/s/si <br />Service Address =22� r1*til"a a..... <br />Billing Address <br />City, State, Zip <br />Owner (Mortgagor) <br />Billing Nart�e <br />Connection By Citt •i at�s�!! <br />CHART N0. <br />��s �,--�-� � <br />��z_ �� _� i <br />, <br />1� <br />Utility Account No. <br />Permit Fee non� <br />Connection Chargels) <br />Total Fee fO�� <br />Signed DO� Nill�z <br />c�:m�� <br />DESCRIPTION: Sewer District — <br />Lot Block Monthly Sewer Service <br />Plat <br />Unplatted Description Monthly Sewer Constr. <br />SEE SKETCH ATTACHED <br />INSPECTION <br />Lateral <br />�butting Lot Line <br />N, S. E, W. <br />pproved By 1. i. lYpl <br />Ciry Enpinasr <br />iSUEC� BY i. iO�A _ <br />nspection By� � �/.7l"7� z« �� <br />�ate Inspected �� ' �� "�I <br />No. 24125 <br />