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' %•vereH <br />e <br />City of Everett <br />Engineering & Community Services <br />Sewer Application and Permit <br />No. 22339 DATE ' '/�'`/��� <br />,r�� � <br />Service Address '" �� s % �•�` "'z''�� <br />Billing Address "' 3�c� ` "'� "�`� , ''r r <br />r; ' / <br />�.i�� ._, �'�ri'.i2 ��A" ;C <br />City, State, 2ip � r � <br />Owner (Mortgagor) � ��' �'t' � r ,'`` �"� ' <br />Billing Name , �'� ''` � �'� <br />.F <br />Connection By � � --�`'' '- <br />Phone ' S"? — `/, <br />litility .4ccount No. <br />G�� <br />Permit Fee 'S U <br />�^,• : . . _. <br />Connection Charqels) <br />6j <br />Total Fee J J _ <br />,/ . <br />Signed ' '��� �-Ct/`�-c <br />c���o�„«� <br />DESCRIPTIGN: Se�ver District <br />Lot Block - . .iy .� <br />Monthly Sewer Service '" <br />Plat <br />Unplatted Description��"��'� ' >'U l �' '' � � �I _ Monthly Sewer Constr. <br />..;,� � , � E !-!! M _ . <br />S�ESKETCH ATTACHED <br />� <br />rY� . .. . i_,. � '.� fi�'i <br />; �.%.�`Crs u.:�i,w ,.tiS � N�� t.L:s., <br />Abutting Lot Line <br />N, S, E, W���- r'!��, / _ft. <br />�.. i'/%� ' <br />ApUroved;8y - -� " <br />' C�ry Enpmcer <br />Issued By_� .__._.��-"`� <br />Insp�c;ion Dy— <br />Datelnspected <br />• <br />ti .. <br />'* �'.nj�`w.t-� :.i�, a,i).1:, � � � - <br />