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everett - <br />� <br />City ot` Everett <br />Sev�ver Application and Permit <br />No. 23336 DAl'E ��S 7 <br />� Av <br />Service Address L7�! L��__�,�� P.�Q <br />Billing <br />City, S� <br />Owner <br />Billing <br />Connection By�"�t�LvJ . <br />Address '� �t � S � "�-� / �'� <br />Phone xs_z, 7� - <br />DESCRIPTION: <br />Lot Block <br />I CHART NO. � S'?_ �. i` <br />Utiliry Account No. ___ <br />Permit Fee % � <br />Connection Chargels) __ <br />l'otal Fee � � <br />Sign <br />Sc�ver District_ <br />G ,�;ihly Sewer Service_____ <br />nthly Sewer Constr. <br />Trunk _ _ <br />Lateral <br />SEESKETCH ATTAGHED <br />!: �: i t_l� i lON <br />utting Lot Line <br />N, S, E, W__ _ <br />proved By�_�„��c'=.� _ <br />C�ty Er'ginccr <br />ied BY �� aE' � � <br />�eclion By <br />elnspected _ ._. <br />No. 23338 <br />