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/L'�' � C- � � <br />everett <br />� <br />City of Everett <br />Sewer Application and Permit ' <br />CHART NO.���"' -��� -� <br />� -�. �: , <br />i <br />7l .� <br />NO. 23QJS DATE �� .i`�=� �% � <br />Service Address �l �} y, ,� ,� � r_�� Utility AccouM No. <br />Billing q�Jdress � i / , -'' <br />, Permit Fee�___ <br />Cit;.State,Zip ! i: �)-; ConnectionCharge(s) <br />Owner (Mortgagor) � T�,t,il F����� <br />Billing Name � <br />Connection By_ /,� <br />Addree;_ <br />_ .;i��n�.J-- <br />'� .-�_ ..il�/�L ,�-i.,,_..: ._ <br />Phone— • <br />v <br />DESCRIPTION: <br />`,���,�-rr Di;irii:t <br />Lot Block <br />Plat � 4 �-,- ����p�.... /s� Monthly Sewer Servi�;�� <br />n <br />Unplatted Desy1fiption Monthly Sewer Con;c�. <br />TVP� Permit: - Trunk <br />Latcral <br />SEESKETCH ATTACHED <br />Abutting Lot L���,: <br />N, S, f;, l'J <br />f <br />�i,i,r�,._�1 8;--- <br />aiv[����:�.�.��.;. _ . _. <br />ssued By <br />� <br />. �'' � <br />�� / <br />nspection BV--/,.,i.�.,o„_, ln: �;,._� ,.� �� --- <br />iate Inspected_ (.� - I � /�� <br />—L— -- <br />N0 2305C� <br />