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r <br />r� <br />L <br />L <br />fr <br />L <br />everett <br />e <br />City of Everett <br />Sewer Application cnd Permit <br />N0. 2/i3Z1 DATE �%�, a? �! �� <br />Service Address �C� T �//�� �-- Utility Account <br />Billing Address <br />City, State, Zip <br />Owner (Mortgagor) �w� �q.J ��_� <br />Billing Name <br />Connection B �//_ec,/ ( ' �{G ✓ <br />Phone 33�- O 6 76 <br />DESCRIPTI ON: <br />Lot ,3 Block—�— <br />Plat �7.c� � — :� �i�� /� <br />Unplatted Description <br />CHART <br />�_,::��J �: �. �� <br />o� <br />Permit Fee_ /O <br />Connection Charge(s) <br />o= <br />Total Fee_.�� <br />Signed �-'— _� <br />__�+� cu:tomerl <br />SEE SKETCH ATTACHED <br />INSPECTION <br />Sewer District <br />Monthly Sewer Service <br />Monthly Sewer Constr. <br />Trunk <br />Lateral_ <br />libutting Lot Line <br />N, S, E, W_ <br />APProved By� -1I - / <br />C�Iy Engineer <br />Issued By ��� <br />-� <br />Inspection By_ �; � � <br />)ate l nsoected �L _ Z _ � <br />No. 24321 <br />� <br />'1 <br />� <br />J <br />J <br />'1\ <br />