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ki <br />City of Everett <br />Sewer Application and Permit <br />CHART N <br />NO. 24742 DATE ��/ L <br />Service Address - �/C/ Utility Account No <br />Permit Fee 30, 0 C) <br />Billing Address <br />City, State, Zip <br />Connection <br />.��an l <br />Owcer (Mortgagor�����(% C� Total Fee �'Vr t�G <br />Billing Name,��0 ( Ci ( TA ( L— <br />Connection <br />M.. <br />DESCRIPTION: <br />Lot Block <br />Pla ✓ A/1 1- 6/5 S T <br />Unplatted Description <br />SEE SKETCH ATTACHED <br />Signed <br />custnmrr <br />Sewer D <br />Monthly Sewer Service <br />Monthly Sewer Constr. <br />Trunk <br />Lateral <br />Lot Line <br />S, E, W <br />By <br />City Engineer <br />1 <br />acted <br />No. 24742 <br />INSPECTION <br />