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everett <br />� <br />City of Everett <br />Sewer Application and Permit <br />No. 2350Q DATE Z�15/00 <br />,ZzZ� — <br />Servi Add 'a'Z� Virqinia <br />J <br />CHART NO. Z- 2�- Z 9—S <br />i�S i �/> <br />,3 zs �� <br />1.�� <br />ce ress Utility Account No._ <br />Billing Address Permit Fee none <br />City, State, Zip Connection Charge(sj <br />Owner (Mortgagor) Total Fee none <br />Billing Name <br />('onnection By �i`Y of Evarett <br />Address_ � �il.ler <br />Signed <br />DFSCRIPTION: <br />Lot <br />Plat <br />Unplatted Descr <br />Tvoe Permir. <br />Remarks: <br />Sc�ver District <br />Block — — — --- — — <br />Montnly Sewer Service__ _ <br />Monthly Sewer Consir. <br />repair <br />�� � , / / <br />% ,ii��7 �( /� <br />/ —' <br />-„ , _ <br />SEESKETCH ATTACHED <br />IIJ,I'LC�f IiiIJ <br />Lateral___ _ _ <br />Abutting Lot Linc j <br />N. 5, E. W— —-- --------it. I <br />'�. ::arron <br />FlPProved [3y <br />Gty Engineer <br />Issued Bv �• L•ond <br />Inspection By <br />Datelnspected <br />No. 235CiG <br />