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CHART <br />everen <br />e <br />City of Everett <br />Sewer Application and Permit <br />�� .� /'ll. /�/ J� L�`� <br />� :� �. .� <br />NO. Z�4ZT DATE 12/27I�2 ;� s<:> -:,' ,- _ <br />3811 Grand Utility Account Na. <br />Service Address__ _ _ <br />� Permit Fee Hone <br />I Billing Address <br />City, State, Zip_ _ Connection Chargels) <br />I�OCIE <br />O�vr,er (Mortgaaor) ._ Total Fce — <br />Billing fJame <br />Connectior� By C.itp of Everutt __ <br />1)on Millar <br />Sig�ed <br />Addf@55 . -- — Customcr <br />Phone <br />CIESCRIPTION: Sewer District_ — <br />Lot Block -- Monthly Sewer Service_ <br />Plat —_ -- <br />Unplatted Description _ Monthly Sewer Constr. <br />Trunk <br />Type Permit: ReFaiz <br />Remarks: <br />Abutting Lot Line <br />yf �� -i y-"/ , F /, .. ,.. � N, S, E, W <br />��� ,. �� . _. _i%,� /��. /.i' � _'ir�.._�T <br />L. <br />' . fir,.� �, f <br />%.7�_ <br />, ��; � _ � A. A. Theal <br />--�—., ,, � Approved By <br />�''� � / /• H . _ City Engincer <br />• E. Bond <br />Issued BY — <br />SEE SKETCH ATTACHED <br />Inspection By �'' l� � �� �� —L-- <br />Datelnspected � " �" � � <br />No. 24427 <br />L I IIJSP[CTION _ <br />-, <br />J <br />