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� <br />everett <br />e <br />City oi Everett <br />Sewer Application and Permit <br />CHART N0. '� <br />N0. L4356 DATE _�/1,/�i''� I <br />Service Address •--: �,-"i ����-��cr�L� _ Utility Account No. <br />D <br />Ril!ing Address Permit Fee �in f� <br />. ,� � <br />City, State, Zip � c�+ L ��_ Connec[ion Chargels) <br />� � q�� `� y �i! <br />Owner (Mortgagor) � �= � ����� Total Fee / 6 <br />I <br />BillingName �--- C�yr�L�..s�-,•-t�- �/S-�� .,� 6� <br />� CL��J / �7� ' i <br />� Connection By �a*-.-.t--- <br />Address Signed � <br />Cuslomer <br />IPhone �G +�— �O 3 -5 __ <br />D SCRIPTION: Sewer District <br />����.i10— <br />L t Block �'� � <br />���— Monthly Sewer Service <br />I Plat ��.-y� <br />! Unplatted Description_ Monthly Sewer Constr. <br />� iype rermn: <br />� Remarks: <br />I <br />SEE SKETCH ATTACHED <br />INSPECTION <br />J <br />� <br />t <br />