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everett <br />e <br />City of Everett <br />Sewer Application and Permit <br />NO. 23517 DATE 3/4/80 <br />Service Address ��5 pakes <br />Billing Address _ <br />City, State, Zip <br />Owner (Mortgagor) <br />Billing Name <br />Connection By �ty of Lverett <br />DESCRIPTION: <br />Lot <br />Plat <br />Unplatted Descripti <br />CHART NO. 2 �—z � S <br />Utiliry Account No. <br />Permit Fee �e <br />Connection Charge(s) <br />Tot�l Fee °On° <br />�osi�U <br />�3 Zs �b <br />�� <br />tlon :tillcr <br />Siyned <br />c��s���R,��� <br />Sewer Di,trict_ <br />Block <br />Monthly Sewer Service_ <br />Monthly Sewer Constr. <br />Type Permit: Rapair <br />Remarks <br />Lateral <br />Abuttiny Lot Line <br />N, 5, E, W <br />IL Warrca <br />Approved By <br />City Engmccr <br />E. ttond <br />Issued By <br />_f t. <br />rv� , H� � 3 � � � 1� J <br />Inspection By �/ <br />_ Date Inspected_J ' .S � � C _ <br />SEE SKETCH ATTACIIED Np� 23517 <br />iNtii'FCiiCr� <br />