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everett <br />e <br />City of Everett <br />Engineering & Community Services <br />Sewer Application and Permit <br />No. 22228 DATE J/b17E.i <br />Service Address 4 (C-1 I``I I> <br />Billing Address /4- 1 LZ <br />City, State, Zip Vt--V-(--I % GUA I <br />Owner (Mortgagor) vtii�c'-K�L-1Z <br />Billing Name <br />Connection By ��;'t7��7T �J✓�yCK/ICL <br />7 <br />Address -> C' � tilt t 7i-' <br />Phone <br />DESCRIPTION: <br />� <br />Lot '�' � � Block < <br />Unplatted Description <br />CHART <br />��o S TcrO <br />a- 17 a � <br />Utility Account No. <br />Permit Fee ` <br />Connection Charge( <br />Total Fee <br />Sign6d—hO-0' f r'li�li <br />Customer <br />Sewer District 1-&11716" �) <br />Monthly Sewer Service ,2 ' S e- j <br />Monthly Sewer Constr. <br />Trunk <br />Lateral <br />Abutting Lot Line <br />N, S, E, W, <br />Approved By • 6 // <br />City Engineer <br />Issued <br />Inspection By - <br />Date Inspected <br />No. 22228 <br />