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ewereh <br />e <br />City of Everett <br />Sewer Applicati�n and Permit <br />No. 22977 <br />Service Address_ <br />Billing Address_ <br />City State, Zip_ <br />Owner (Mortgagi <br />Billing Name_ <br />Connection By_ <br />Address._ <br />Phane_— <br />DESCRIPTION: <br />Lot <br />Plat <br />Unplatted Descr <br />Tvoe Permit: <br />DATE <br />CHART N0. � ' <br />�D 5�� <br />,,,�;f <br />� <br />Utility Account No. <br />Permit Fee <br />�unnection <br />Total Fee_ <br />Signed <br />Sewer District <br />Block Monthly Sewer Service. <br />Montl�ly Sewer Constr. <br />Trunk _ <br />SEE SKETCH ATTACHED <br />It�SPECTION <br />Abutting Lot Line <br />N, S, E, W, <br />Approved By <br />City Engmcer . <br />Issued <br />Inspection By ��"��'� " '^�7 <br />Da'einspected / � �� _ / <br />No. 22977 <br />