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Wit <br />city of Everett <br />Sewer Application and Permit <br />4/20/B1 <br />No. 23967 DATE <br />1721 Rainer Avenue <br />Service Address =�— <br />Billing Address <br />City, State, Zip <br />Owner (Mortgagor) <br />Billing Name <br />City of Everett <br />Connection By <br />DESCRIPTION: <br />Lot B <br />Plat <br />Unplatted Description- <br />SEE SKETCH ATTACHED <br />CHART NO. X <br />Posr6p 5,. I `f 81 <br />Utility Account No. — <br />None <br />Permit Fee <br />Connection Charge(s)— <br />None <br />Total Fee <br />Sign <br />Don Hiller <br />Sewer District_ <br />Monthly Sewer Service. <br />Monthly Sewer Constr. <br />INSPECTION <br />ateral <br />Lot Line <br />S, E, W <br />A. R. Thenl <br />City Engm <br />E. Bond <br />77 <br />n By <br />iected / <br />NO. 23967 <br />