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/L C i � <br />everett �z�''��' S <br />� <br />City of Everett <br />Sewer Application and Permit <br />No. 23371 <br />DATE _ <br />x <br />Service tlddress " <br />Billing Address _ _ <br />City, State, Zip <br />Owner (Mortgagor) <br />Billing Name <br />Connection Bv <br />Phone <br />DESCRIPTION: <br />Lot <br />Plat <br />Unplatted Descript <br />Block <br />Type PermiC � <br />CHART N0. F— S— 2$ — S <br />�os�./� <br />�� 3i -�a <br />�� <br />� <br />Utility Account No. <br />Permit Fee <br />Connection Chargel <br />Tot.�l Fee ___ _ <br />� <br />SEE SKETCH ATTACHED <br />ilv:�i �( <br />Sewcr District_ <br />Monthly Sewer Service <br />Monthly Sewer Constr. <br />Lateral <br />Abutting Lot Line <br />N, S, E, W <br />Approvcd By <br />G�y E� <br />Issued Bv— ' <br />— — — ft. <br />i <br />Inspection By � �r-' �__.�______ <br />Datelnspected � ��-U � � j � 1 _ <br />N�, 23371 <br />I� <br />