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CHART NO. D 2-91-19'S <br />everett <br />e <br />City of Everett <br />Sewer Application <br />i <br />) <br />and Permit <br />s/25/HD <br />NO. 23717 DATE <br />2933 Roeiefeller <br />Service Address <br />Billing Address <br />City, State, Zip <br />Owner (Mortgagor) <br />Billing Name_ <br />Connection By_ City of Everett <br />DESCRIPTION: <br />Lot - <br />Plat <br />Unplatted Descripti <br />Utility Account No. <br />Permit Fee none <br />Connection Charge(s) <br />Total Fee none <br />Don Miller <br />Signed_ <br />Customer <br />Sewer District <br />Block Monthly Sewer Service <br />Monthly Sewer Constr. <br />Remarks: <br />s- <br />SEE SKETCH ATTACHED <br />Lateral <br />Abutting Lot Line <br />N,S,E,W <br />Approved By it. Warren <br />Cay Engmcer <br />r.. Bond <br />Issued By -- <br />Inspection By /� fin' <br />Date Inspected �T <br />No. 2371T <br />INSPECTION <br />