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everett <br />e <br />City of Everett <br />Sewer Application and Permit <br />No. 24035 <br />DATE �/15/81 <br />Service Address �611 Rainies <br />Billing Address <br />City, State, 2ip <br />Owner (Mortgagor) <br />Billing Nam <br />Connection <br />DESCRIPTION: <br />Lot <br />Plat <br />Unplatted Descr <br />Type Permit: <br />C1tY o! E�sr�tt <br />CHART NO. U 2� "? �t - S <br />q• z4-8� <br />�� <br />Utility Account No. <br />Permit Fee non� <br />Connection Charge�s) <br />aoa� <br />Total Fee <br />ltOp Mill�i <br />Signed <br />Customcr <br />Sewer District <br />Block <br />Monthly Sewer Service <br />Manthly Sewer Constr. <br />Remarks: r�ptir <br />,:i�'r..;/Fn.r i��',�-/�1 <br />I l r �i�. �.� i+'. <br />., ( , i / ! <br />Lateral <br />�Abutting Lot Line <br />�.,-. � N, S, E, W <br />SEE SKETCH ATTACHED <br />INSPECTION <br />Approved By �' R. Theal <br />Cily Engineer <br />F. 8oad <br />Issued Bv <br />Inspection By �� C� J 1ln- �., �,..�- <br />Date Inspected , �-7"�� <br />No. 24035 <br />