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everen <br />e <br />City of Everett <br />Sewer Applicction and Permit <br />NO. 2358� DATE �'-� ,` _ ( . <br />Service Address ' ` ' `'- � <br />� � `. _ <br />Billing Address 4 � �-- �- - <br />City, State, Zip L:=:_� . �_:��t:_�-T' !�''�' ;�' f c: <br />�., � '_ t�,,. <br />Owner (Mortgagor) <br />i <br />Billing Name r 1 - C' `"' — <br />Connection By { � '� r _ ` ', <br />� `' � l i," C , . <br />Address k � � � ' <br />Utility Account No. <br />` <br />Permit <br />�. <br />Connection Chargels) <br />._ L� <br />�' - <br />Total F <br />�' <br />,; � - /;�' �`J <br />i� ''"i �// ��/1J� � � �Y-�:� :•/` <br />$igned � � Cusromer <br />Phone " ` <br />DESCRIPTION: <br />Sewer District <br />Lot •�' `' Block �- Manthly Sewer Service. <br />Plat 1— �<_.r..._; r i_...,_ :: 1` � . <br />Unplatted Description Monthly Sewer Constr. <br />INSPEGTION <br />Lateral <br />�tting Lot Line <br />N, S, E, W. <br />�� [ (.%. ,i- �r (�;_.� <br />proved BY <br />City Engineer <br />ued <br />;pection <br />l_ ��:. , .�.�� ., : ,�,,.� <br />te Inspected <br />No. 23584 <br />