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I <br /> CHAi1T N0. <br /> everett <br /> e <br /> City of Everett � <br /> Sewer Application and Permit <br /> .�aSt�i ,� .��-�� <br /> No. 24435 DATE � . 3 — � -�g- <br /> , <br /> Service Address /���C��" `��`—'7�J'C- �� Utility Accc�unt No._ <br /> /2/C �7 S%fi � �O "�' <br /> Billing Address C~� Permit Fce <br /> City, State, Zip� v���-77 � `� �� 7 Connection Chargels) <br /> � an <br /> Owner (M�rtg�gor) `� <. , �--lJ7`"t'C/E Total Fee /L' <br /> Billing Name_ � 7,�/'Yl�e�- <br /> Connection By__�,/_�/ti��_ -- � <br /> � �: <br /> , Address _ _._ Signe � ` � - <br /> �Customer � <br /> Phore_ -� �-'�'�'� 2" I <br /> DESCRIPTION: Sewer District <br /> Lot Block <br /> Monthly Sewer Service <br /> Plat <br /> Unplatted Description Monthly Sewer Constr. <br /> — Trunk <br /> Type Permit: ��E�/��� _ <br /> Lateral <br /> _ i <br /> Remarks: I <br /> Abutting Lot Line <br /> N, S, E, W ft. <br /> e > <br /> — Approved Bv� �\ �C=f)L <br /> �—�—G y Engineer <br /> Issued By L C�L-G/9/-�/��' <br /> I � � � <br /> � Inspection By_/ � '��'' ""� <br /> I <br /> Date Inspected_ � �� �y-� � <br /> SEE SKETCH ATTACHED N�• Z4435 <br /> � <br /> INSP[CTION <br />