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M <br />everen <br />e <br />City of Everett <br />Sewer Application and Permit <br />No. 23282 <br />Service <br />Billing <br />City, S1 <br />Owner <br />Billing I <br />Connection By <br />dC.. <br />DATE�����_ <br />Phone ':! o2 <br />CHART NO. T 9-V <br />6'6 I-! '`- <br />Utility Account No. <br />- aZ Permit Fee <br />Connection Charge(s)_ �72•��•� <br />Total Fee �Ja�� <br />l <br />Signed <br />Customer <br />DESCRIPTION: ,— Sewer District <br />Lot :;��' x�'-Bloc_ <br />Plat � Monthly Sewer Service. o?-� <br />Unplatted Description Monthly Sewer Constr. <br />Type Permit: <br />Remarks: .31 <br />(� ConJctcr£�,� / u <br />l7 o/lSfiC. <br />I <br />SEE SKETCH ATTACHED <br />Latera <br />Abuttin; Lot Line <br />N, S, E, W. <br />Approved By <br />City Engineer <br />Issued <br />nspection By QrrLUrM 62 <br />)ate Inspected_ ! h - 29 <br />No. 23282 <br />INSPECTION <br />