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everett . <br />e <br />City of Everett <br />Sewer Application and Permit <br />No. 22880 <br />Service Address_ <br />Billing Address_ <br />City, State, Zip_ <br />pwner (Mortgagor) <br />Billing Name_ <br />Connaction By_ <br />Phone <br />DESCRIPTION: <br />Lot <br />Plat <br />Unplatted Descr <br />Tvoe Permit: <br />DATE <br />CHART NO. R ZO "'z�i'"S <br />�S �G � <br />� <br />�� <br />� �Z.� - � . <br />_ Utility Account No. <br />Permit Fee <br />Connection Chargels) <br />_ Total Fee <br />Signed <br />customcr <br />Sewer District <br />Block Monthly Sewer Service. <br />Monthly Sewer Constr. <br />SEE SKETCH ATTACHED <br />irlsP�cTior� <br />Abutting Lot Line <br />N, S, E, W. <br />Approved By <br />arv E� <br />Issued By <br />i <br />Inspection By � � <br />� .� '....,�is%�� <br />Date inspected � � l " �,�-- <br />No. 22880 <br />