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evcretl <br />� <br />City of Everett <br />Sewer Application and Permit <br />CHART NO. � �' ��/� <br />No. 23045 DATE - `- % ` �_ <br />( C��,��o�,� cn <br />Service Address 49 �� � �fZ�_��e_ % Utility Account No. �y ..3 �� <br />. _ � � n �, o�� <br />Billing <br />City, S <br />oWne� <br />Billing <br />Permit Fee— 3 U <br />�/ G�` <br />Connection Charge(s) 6 �� <br />Total Fee <br />3 a �� <br />Connection By (,C�2->Cr..r' C.,r-�� - _ <br />Address�l `��Q % G `��e�� Signed <br />Phone_�Ga —G90 a ��C/� <br />DESCRIPTION: Sewer District� �1 � /� <br />Lot .� ck � �_ -�-_ /� <br />Plat Monthly Sewer Service •?�1 '� <br />Unplatted Description ' _ Monthly Sewer Constr. <br />SEESKEfCH ATTACHED <br />Trunk � .0 0 %(�G ��— <br />s0. <br />Lateral '�. �/p 5'S�/ <br />Abu[ting L Line <br />,N�E, W �0 � ft <br />Approved By_ ' / <br />Cny Engincer <br />Issued <br />Inspection By �i�t `�� <br />i�ate Inspected �% � � �J' 7/ __ <br />No. 230d5 <br />�� <br />