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CHART NO. ��� ' � — ��' -' — <br />evereli <br />e <br />City of Everett <br />Sewer Appli�ation cnd Permit <br />N0. 24139 DA7E 1/��9! <br />�609 23zd Ctr��t +1�f���""' "UtilityAccountNo._ <br />Service Address poe� <br />Permit Fee <br />Billing <br />City, SWte, Zip <br />pwner (Mortgagor) <br />�� _;�, <br />i- Z ��?� <br />Connection Charge(s)�-- <br />noee <br />Total Fee <br />Billing Name <br />Connection By Cit o! s��r�« DOe Mill�t <br />Signed c�sto�� <br />Address_ <br />Phone <br />$ewer District <br />DESCRIPTION: <br />Lot _ Block — Monthly Sewer Service <br />Plat Monthly Sewer Constr. <br />Unplattad Description _ _ <br />SEE SKETCH ATTACHED , <br />INSPECTION <br />\butting Lot Line <br />N� $, E. W <br />�. �. ��al <br />4pproved 3y c rv Ene.��M <br />g, fona <br />Issued <br />Inspection BY <br />i,j', C% ,.'/%i� n�= <br />Datelnspected � � � � L <br />No. 24139 <br />