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everett � <br />e <br />City of Everett <br />Engineering & Community Services <br />Sewer Application and Permit <br />rvo. 21974 DATE ,� � �•% <br />Service Address •" -' �� 1 r� '�`-�Cf'E F!!L% E./� <br />BillingAddrass �%�r �' C'�;t/�':G!/ <br />City, State, Zip •`'��� ����L �(-`-' <br />,� ; <br />Owner (Mortgagorl •--'�'�,C .�' ; "' �' l , 1 7" - <br />/ <br />BillingName �'�L��- <br />Utility Account No. <br />1 � C.'Ci <br />Permit Fee �--�' ' <br />Connection <br />-1 � C CJ <br />Total Fee --� ' _ <br />Connection By L. LC-.t�' .��w'/!r +CC %�('.t j,l i;4'7f,•r' <br />- �. <br />Address �� L`% 7'— 7 � /t/ L�'_ Signed '--'`Ec'Z._-����"'' `'`t G-� <br />- cu:romer <br />Phone �i. � '�� ` '' ;-' �l z <br />DESCRIPTION: Sewer District �'' =�nf� 't ' J <br />Lot %�= := " L � Block ' � � � ��onthly Sewer Service �'!�- ���L- �� <br />Plat �-. c� !-:F 'E 7 i <br />Unplatted Description_ Monthly Sewer Constr. <br />Type PermiL• �I. JL-1 Li �X /N�G7�O.!/ <br />Remarks: <br />SEE SKETCH ATTACHED <br />INSPECTIOrI <br />Lateral <br />Abu[ting Lot Line <br />N, S, E, W <br />Approved By � . � !�'v��"'` �1 <br />Ciry Engmeer <br />Issued BY 4" <br />Inspection <br />Date Insp <br />�, /_I LC il /.�:Ji✓ <br />� .� <br />no. ? 1._l 7 U <br />