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evereff <br />� <br />City of Everett <br />Sewer �4pplication and Permit <br />No. 25265 <br />DATE �{� % � �9e �' <br />Service Address�/ � �.l /j�F �/�� <br />��-_/11/eUtility Account No <br />Billing Addre��/����4/ <br />/ ,{ <br />City, State, Zi,o/"�A _Y�Y—_�/���Q <br />Owner (Mortgagor)����C�dL S <br />Billi�g Name��� �!i � ��/��<' <br />Connection By � <br />Phone�-�'"�('/ 7 <br />DESCRIP IQN: <br />Lot �� Block � <br />Plat �_CL7� L� FJ � <br />Unplatted Description__ <br />Permit Fee_ � �� � �% <br />Connection Charge(s�_ <br />Total F=e �v <br />Signed—f 1 <br />Cusmrt. <br />SEE SKETCH ATTACHED <br />INSPECTION <br />Sewer District �%L <br />Monthly Sewer Service <br />Monthly Sewer Co�str. <br />Trunk <br />Lateral <br />Abuiting Lot Line <br />N, S, E, W_ <br />4PPrcved By � %: ; <br />C�ry Enginecr <br />ssued By ���� � � <_.�__.. , i / <br />\ <br />nspection By i <br />ate Inspected ` �� ��J <br />N�. 25265 <br />� <br />N <br />� <br />