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everett <br />� <br />City of Everett <br />c.-�.7q <br />�-=�-�� <br />Sewer Application and P�rmit <br />No. 23043 <br />Service <br />Billing <br />City, Si <br />DATE ��,��7 � <br />� <br />Owner (Mortgagor} � .,c.e � i - o� <br />Bilting Name �Gl..--,�.,�z._� <br />Connection By ��., y <br />Address <br />Phone 3 �% — .�`f.� �/ <br />DESCRIPTION: <br />Lot_ /U <br />Plat __si/fz� <br />Unplatted Descr <br />CHART NO._ <br />� 3s-Z9-y <br />r��� <br />���/��� <br />1/�f�- <br />ility Account No. / �� / <br />rmit Fee_ <br />30 °� <br />o� <br />nnection Charge(s� •��d <br />c <br />Total Fee_ _7� � <br />Signed � � - <br />Cusmmcr <br />Sewer District ,�� � <br />� <br />- � SD <br />� � Monthly Sewer Service_ v� '� _ <br />SEESKETCH ATTACHED <br />INSPECTION <br />Monthty Sewer Constr. <br />�` � � <br />Trunk / � /.�� ��/ d <br />�� <br />Lateral ,�-:?.5� ,�`/� <br />Abutting Lot Line <br />N, S, E, W <br />Appro� <br />Issued <br />Inspection By �'-�• L� � <br />�ate Inspected_ �C ' ��.� '! � <br />No. 23043 <br />