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everen <br />� <br />City of Everett <br />Sewer Application arid Permit <br />N0. GSZOZ DATE <br />Service Address � �� �� Utility Account No._ � G 1 -J <br />Billing Address S.� '�� •�C Permit Fee <br />City, State, Zip <br />Connection <br />Owner (Mortgagor�S� ��"�'—� Q ��`�� Total Fee <br />Billing Name � ' L- <br />Connection Bv � � <br />,.: 1 J,; f ; �� i <br />Phone - �/ ' • <br />DESCRIPTI ON: <br />Lot Block <br />Plat _ <br />Unplatted <br />Signed <br />Customer <br />SEE SKETCH ATTACHED <br />INSPECTION <br />Sewer <br />Monthly Sewer Service <br />Monthly Sewer Constr. <br />Trunk <br />Laterel <br />Abutting Lot Line <br />N, S, E, W <br />\ <br />Approved BY .. <br />City Enpineer <br />I ssued <br />Inspection B � lP�ita c+n <br />Date l nspected � - �' ' � � <br />No. 25202 <br />� <br />� <br />