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CHART NO. <br />� — � :- � L �i � S <br />everett <br />� <br />City of Everett <br />Sewer Application and Permit <br />��o. 23367 DATE ���%/�% �7 L <br />Service Address y � �CJ ���— ��!-___—��-1"� �tility Account No <br />Billiny , <br />City, S1 <br />Owner <br />Billing <br />Connec <br />Address <br />Phone � ��' J��� <br />D[SCRIPTION: <br />Lat - 6 Bloc�k7�— <br />PIaL� ,�� LL�ir�_ 1� <br />Unplatted Description <br />� yyz�"" <br />0 <br />Permit Fee 3� � <br />/ / D�� <br />Connection Charge(s) 6 3,h — <br />-,� a� <br />Total F��e � _ <br />� --. - <br />Signed � / � <br />. . customcr <br />SEESKETCH ATTACHED <br />II�SI'�C11GJ <br />�� �Sewer District • <br />Monthly Sewer Service rY�^ ��,F _ <br />Monthly Sewer Constr. <br />s�- <br />Trunk�,f,iJ a� D <br />.� i- �q l'% <br />Lateral�oC.h .�/S <br />Abutting Lot Line <br />/� S, E, W �„i . � _—. it. <br />�/. � ) <br />llpproved By��1 - .��/,e �-/e v' <br />Gty gincer <br />� <br />ISSUCd By 1� <br />Inspection By— `�= �� �-�� "' <br />Date Inspected � � �� ' ����"�'� ' � - � <br />No. 23367 <br />