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CHART N0. <br /> everett <br /> � <br /> City of Everett <br /> Sewer �►pplication and Permit <br /> NO. 2�)037 DATE u. i � inna — <br /> Service Address 1410 ^tereve vrive_ Utility Account No._Tc�c, � <br /> BillingAddress 724 n,�atin n�aa e+_e_ _ PermitFee 3g, <br /> City, State, Zip.u-.=�_•+ii�TS1a 93270 Connectio� Chargelsl�z�g,gp <br /> Owner (Mortgagor�_�,_,7a�� Total Fee �o no <br /> Billing Name Samo prdinaneu t�984-83 <br /> 800.00 <br /> Connaction By_ <br /> Ad.iress S igned_ <br /> Cu5lamcr <br /> Phone 65�-]322 <br /> DESCRIPTION: Sewer District �+^ � *T <br /> Lot � Block�_— <br /> Monthly Sewer Service — <br /> Plat — <br /> ever�y s v. <br /> Unplatted Description Monthly Sewer Constr. <br /> Trunk <br /> � Type Permit: <br /> � Lateral <br /> Remarks: <br /> Abutting Lot Line <br /> N, S, E, W _ ft. <br /> Approved By r u Theat <br /> Ciry Engmecr <br /> Issued By E. i�cL <br /> Inspection By��f �""D^-- <br /> Date I nspected 5'-Ly$� "� __ <br /> SEE SKETCH A'iTACHED N�• �JO�� <br /> INSi'f_CTIUN <br />