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evereri <br />� <br />City of Everett <br />Sewer Applicat�on and Permit <br />N0. 24171 DATE a �a! � �' <br />_�.Q: f�" <br />CHART <br />Service Address� � ��� Utility Account No. � <br />, �, o .�-- <br />Billing Address �` Permit Fee <br />City, State, Zip �v�--' ��Z `T— � �� �03 Corniection Charge(s) <br />Owner (Mortgagor) � �,� � Total Fee� <br />Billing Name � <br />Connection <br />Address <br />Phone o�.5'� � �ct�`3 <br />DESCRIPTION: <br />Lot-� ,!»—K�-1" �� <br />Plat �"'d <br />Unplatted Description <br />Sig�ed_ C�istomer <br />Sewer District <br />Monthly Sewer Service. <br />Monthly Sewer Constr. <br />Trunk <br />La[eral_ <br />Abutting Lot Line <br />N, S, E, W_ <br />SEESKETCH ATTACHED <br />INSP[CTION <br />Approved BY � ' /� '� <br />��iry Enyinccr <br />�-- � <br />Issued By `'� <br />Inspection By `"� �� �� _''`' "i1��"— <br />,� �_ , �- <br />Date I nspected ! `l �� ' <br />No. 24171 <br />._o � <br />