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u <br />everett <br />� <br />City of Everett <br />Sewer Application and Permit <br />No. 23205 <br />DATE %� <br />Service Address <br />Billing Address <br />iCity, State, Zip <br />Owner (Mortgagor) �..�.ce-�f /.l� �,//,-�t' - <br />i <br />Billing Name <br />i Connection By <br />I Phone <br />� DESCRIPTION: <br />� Lot <br />Plat <br />Unplatted Descripti <br />i <br />Type Permit: <br />CHART NO. Z�—�7—.� <br />�as�E-� <br />7-i7~.'s <br />�� . <br />Utility Account No. <br />Permit Fee <br />Connection l'.harge� <br />Total Fee_ <br />Signed <br />a�:�o�„�, <br />Sewer District <br />Block <br />— - Monthly Sewer Service. <br />— Monthly Sewer Constr. <br />Trunk <br />SEE SKETCH ATTACHED <br />INSPFC1t0�J <br />Abutting Lot Line <br />N, S, E, W ft. <br />Approved <br />Issued B <br />Inspection <br />Date h�oe <br />cnv <br />%' /O ^ <br />No. 23205 <br />