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CHART NO. <br /> everett <br /> e <br /> City of Everett <br /> Sewer Application and Permit <br /> NO. 25236 DATE �� 7 ��5 _ <br /> Service P.ddressJ��/ � Utility Account No. <br /> � <br /> Billing Address � Permit Fee p2 -� — <br /> City,State, Zi ,� - ��� �O��T� Connection Charge(s) <br /> Owner (Mortgagor) - �� Total Fee <br /> � � <br /> Billing Name <br /> Conr.ection � � -- <br /> � - ` ���� Signed ' � . -_ <br /> Address c�:�omP� <br /> Phone��g�Q <br /> DESCRIPTION: Sewer District <br /> Lot B� k 3� Monthly Sewer Service <br /> Plat_�� <br /> Unplatted Description Monthly Sewer Constr. <br /> -- Trunk <br /> Type Permit: � <br /> Lateral <br /> Remarks: Abutting Lot Line <br /> N, S, E, W ft. <br /> Approved By �/3 ' v7 " ��� <br /> Ciry Enpinem <br /> ISSU2d By!� ' �� '^` — <br /> Inspection Sy� ` -�vP/�� <br /> Datelnspected iV" Y F'r <br /> SEE SKETCH ATTACHED NO. 25236 <br /> !tri:i ECTION <br />