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i <br />City of Everett <br />Engineering & Community Services <br />Sewer Application and Permit <br />NO. 22050 DATE (t�IU �7 % <br />CHART NO.&— SZ'_24—S' <br />Po s 7_4 .d <br />/- ? - 71 <br />p <br />/` i ' <br />Service Address 4- t1 i G' L! 'tom 1p�V t Utility Account No. <br />Billing Address Clj, `- c_-X_. LL4\4 Permit Fee <br />City, State, Zip L LJ G'z C Connection Charge(s)_ r 7 U ��I lt• �� 7 <br />Owner (Mortgagor) �� t—�. ' h SIC&4_1L L lr Total Fee C U <br />Billing Name_. J <br />Connection By <br />Address C�1 F._ c� Signed <br />Customer <br />Phone ' -' `� � �" �_' <br />DESCRIPTION: <br />Lot - BI <br />Plat IJ,'( L. t_ <br />Unplatted Description_ <br />Sewer District_L�'�G'� t <br />Monthly Sewer Service <br />Monthly Sewer Constr. <br />Trunk s <br />Lateral L 2 '7 <br />Abutting Lot Line <br />N, S, E, W <br />P 'proved ByL '. <br />City Engineer <br />Issued By L C In, L. L 1, 1 , ) <br />Inspection By <br />Date I nspected_ <br />ND. 22050 <br />