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evereti <br />� <br />City ot Everett <br />$ewer Application and Perrnit � <br />No. 23348 DATE ��'f - �/�/ <br />� �� ��� � <br />CHART NO._� �� � !'S <br />Service Address �"x Utility Account No. <br />Billing Address ' / Permit Fee_�a Q—� <br />City, State, Zip ; , i <br />Owner �Mortga�orl ��(Z !-�ix�<G�' <br />Billing <br />Connection <br />DESCRIPTION: <br />Lot <br />Plat <br />UnF <br />Connection Chargel <br />c� <br />Totul Fee__ <br />Signed------ <br />cvaovr=� <br />Tyor: Permir. ,r <br />Remarks: <br />SEE SKETCH ATTACHED <br />Sc�vcr DisVici <br />Monthly Sewer Servicc <br />Monthly Sewer Constr. <br />Trunk <br />Lateral <br />Abutting Lot Line <br />N, S, f_, 1V_ _ft. <br />�lpproecd By <br />c��v E�,y��,«� <br />Issued B <br />/ . <br />InspectionBy���i �M<<'-_-�___ _ <br />�� — <br />Date I nspected,jc'' '- ? G - -' ` � <br />No. 23348 <br />