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everett <br />e <br />City of Everett <br />Sewer Application and Permit <br />No. 24433 <br />Service <br />Billing <br />City, S <br />. i <br />Owner (Mortgagor) — <br />Billing Name <br />Connection By ������� <br />DATE f,�'�/�� <br />Address <br />Phone �/`�' 9— �� 3� <br />DESCRIPTION: <br />Lot � <br />Plat _ <br />UnplatteJ Descr' tio <br />CHART N <br />Jtility Account No. <br />Permit Fee �a <br />1;;,_?;, f , <br />Connection Charge�s) <br />a�-- <br />Total Fee 3 � <br />$19ned Customer <br />�. .,p � ` - <br />Sewer District ��� <br />Montlily Sewer <br />Monthly Sewer Constr. , <br />Trunk_� <br />Lateral__ ���c%��� <br />SEE SKETCH ATTACHED <br />INSPECTION <br />Abutting Lot Line <br />N, S, E, W <br />Approved BY � Ciry En incer <br />� � <br />Issued By � <br />� <br />'Q / <br />inspection By_ � � <br />Date Inspected � � � � � � <br />No. 24433 <br />--, <br />� <br />