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, i' <br />! <br />t <br />evereri <br />e <br />City of Everett <br />Sewer Application and Permit <br />No. 23969 DA7E . �. ' I( � <br />Service Address��.— Utility Account N <br />Billing rlddress� Permit Fee <br />City, State, Zip <br />Connection Charc <br />Owner IMortgagor� Total Fee _ <br />Billing Name — <br />Connection By <br />Address Signed c��smm�� <br />Phone <br />DESCRIPTION: <br />Lot <br />Plat <br />Unplatted Descr <br />Tvn� prrmit: <br />Block— <br />Sewer Disvict <br />Monthly Sewer Service, <br />Monthly Sewer Constr. <br />SEE SKETCH ATTACHED <br />INSPECTICN <br />A�utting Lot Line <br />N, S, E, W. <br />Approved BY_ <br />issued By_ <br />Inspection <br />Datelnspe <br />EnBinecr <br />No. 23969 <br />