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ki <br />City of Everett <br />Sewer Application and Permit <br />CHART NO. '11cCi Z 57-.S <br />No. 23366 DATE 11/G/79 <br />Service Address 140G Chestnut .,�. �: C� �(f�/.t,,,y Account No._ <br />Hone <br />Billing Address _ Permit Fee <br />City, State, i <br />Owner (Mort <br />Billing Name <br />Connection I <br />Phone <br />DESCRIPTION: <br />Lot <br />Plat <br />Unplatted Descr <br />City of Everett <br />Block <br />Type Permit: repair <br />Connection Charges <br />Total Fee <br />Hone <br />Ion Killer <br />Signed <br />Customer <br />Remarks: <br />-> <br />SEE SKETCH ATTACHED <br />Sewer District <br />Monthly Sewer Service. <br />Monthly Sewer Constr. <br />Trunk <br />Lateral_ <br />Abutting Lot Line <br />y N, S, E, W_ <br />Approved By H. Warren <br />City Engineer <br />E. Bond <br />Issued B <br />A <br />Inspection By?�,�/,-7�pG"�' <br />Date Inspected <br />No. 23366 <br />INSPECTION <br />