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cverett <br />e <br />City of Everett <br />Sewer Appiication and Permit <br />No. 23590 <br />DATE <br />uos ou.s scs«e <br />Service Address <br />�6�1 Ce1DY <br />Billing Address <br />Ews�tt. Na. 98203 <br />City, State, Zip <br />Mi7co Et�rl� <br />Owner (Mortgagor) <br />Mik� Eb�zl� <br />Billing <br />Cannection <br />�� �arle <br />4631 O�lby <br />252-963a <br />.i3oiao <br />CHART NO. � 2 I- 2�I -S <br />���P 8���0 <br />� <br />75903-5 <br />Utility Account No. <br />�0.00 <br />Permit Fee <br />677.50 <br />Connection Chargels) <br />]0.00 <br />Total Fee <br />, ,. �'� .� �:r .�-_ <br />� <br />^":"s'_;.�. �. !:,L� � ,('!�- <br />Signed �!�''� Cusromer <br />]1 sond II <br />Sewer Uistnct <br />DESCRIPTI�N: 3�80 <br />Lot Block Monthly Sewer Service_--- <br />Plat sh°rt tLt 1202-49-79 <br />Unplatted Description Monthly Sewer Constr. <br />1.15 255.00 <br />Trunk <br />_ .. t7w C'nan�ct�on 2.25 �2Y.50 <br />SEE SKETCH ATTACHED <br />INSPECTION <br />>butting Lot Line <br />N, S, E, W <br />N. Watr�n <br />4pproved By �� E� nee. <br />E. �ot� <br />Issued <br />��1 <br />Inspection BY—.�-,-� ° <br />Date Inspected 3 � �JLY � � <br />No. 23590 <br />