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D <br />j City of Everett <br />Sewer Application and Permit <br />No. 23237 DATE 7�> <br />Service Address Utility Account No. <br />Billing Address / j Permit Fee <br />City, State, Zip Connection Charge( <br />Owner (Mortgagor) Total Fee <br />Billing Name <br />Connection By_ <br />Address <br />Phone <br />DESCRIPTION: <br />Lot_ <br />Plat <br />Unplatted Descript <br />Tvna Parmitt <br />Block <br />Signed J / <br />Customer <br />Sewer District <br />Monthly Sewer Service. <br />Monthly Sewer Constr. <br />Remarks: (r,C(� <br />rl <br />` 0 <br />SEE SKETCH ATTACHED <br />INSPECTION <br />Lateral <br />Abutting Lot Line <br />N, S, E, W <br />Approved By <br />C ty Engl"eer <br />Issued <br />Inspection <br />Date Inspe <br />No. 23237 <br />