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everett <br />e <br />City of Everett <br />Engi�eering & Community Services <br />Sewer Application crnd Permit <br />N0. 7_,, ( L F3 �� DATE y" S 7% <br />i <br />Service Address == L' -�~ Gf_��:r'rEz-L[_.L <br />Billing Address � 7-��"� L <br />City, State, Zip�-� �=�T LL� �t,� 20 �— <br />Owner (Mortgagor�/`��«<--�-�t-Z�- �L4l��:.�` <br />Billing Name �".-�'� i � <br />Connection By �•-� e'�"�-k�'Y" � �- <br />r <br />Address ��-`��Z. ( C: � T f � �-r. �J-» <br />SZob - �/ 5; � � <br />CHART NO..��,- �� �� - y�l �S <br />f!'o � °�"`',� � <br />Utility Account No. <br />Permit Fee <br />Connection Charge� <br />Total Fee <br />�1 <br />Signed�_y_ <br />2• �� <br />.,, � <br />�� � <br />I i�-_-.... . <br />DESCRIPTION: Sewer District <br />Lot � -7 '� �p% Blocic � �" �+'— <br />Plat �.(..�f�1� G'�-- Monthly Sat•:�r Service <br />Unplatted Description Monthly Sewer Constr. <br />Abutting Lot Line <br />N, S, E, W _ ft. <br />Approved By ' /��'�` �'�i <br />Ci�y Enpineer T <br />Issued By � �����1�'�`� <br />Inspection By�"� -'�uZ�'^� <br />Datelnspected S S 77 _ <br />N0. � � t� <br />