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evereH <br />e <br />City of Everett <br />CHART NO. Y �� �z'� — ' <br />,� �pS�1� <br />I ` <br />Sewer Application and Permit <br />rvo. 23094 <br />DATE ` ' �� !'o� <br />ServiceAddress ���� %�i-�-�i_� s�a'—i� <br />Billing Address �) ��� S <br />City, State, Zip��QS�{i�.��t�i�_ <br />Owner (Mortgagor) � �_��r--`_ yC��-,_E � <br />� <br />Billing Name <br />Connection <br />DESCRIPTION: <br />Lot 2 �B —oc—k �7/ <br />Plat �C�rJ6�ly�ic ,e��� <br />Unplatted Description <br />Utility Account No. <br />�� <br />Permit <br />Connection Charge�s) <br />Total Fee <br />�� G'/ <br />Signed <br />cu:rort <br />Sewer District <br />Monthly Sewer Service. <br />_ Monthly Sewer Constr. <br />Trunk <br />Latera I <br />Abutting Lot Line <br />N, S, E, W_ <br />SEE SKETCH ATTACHED <br />INti{'(;CTION <br />Approv�d By <br />C�ry Enginccr <br />Issued By <br />.._� � f:.. <br />Inspection By ��N �� �'`'� <br />'`� _ 7Q <br />Date I�spected v _ �� ' 1 <br />rvo. 23094 <br />