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CHART N0. <br /> everen <br /> e ���� ,�� <br /> City of Everett ?- l- � Z <br /> l%`r <br /> Sewer Application ond Permit <br /> N0. 2414H DATE �v.� �7i <br /> '� �l f� (.0 �. �60� Utility Acr.ount No. . <br /> Service Address=_—� , � e� <br /> � Permit Fee_ U ��f'�`� <br /> Billing Address "�� °' <br /> �.�f' ?�f Connection Chargelsl_ <br /> City,State, Zip /O d� <br /> Owner (Mortgagor/) — <br /> Totai Fee <br /> Billing Name �'J" �f'-�' <br /> Connection By��� L^ "��� <br /> Address��—� �-�`—'�' "���^ed Customer I <br /> Phone.�—�� 3 � ' <br /> Sewer District <br /> DESCRIPTION: O <br /> Lot�� B�ock� MonthlySewerService <br /> Plat f �h'�^ <br /> �' Monthly Sewer Consv. <br /> Unplatted Description <br /> Trunk <br /> Type Permit: Lateral <br /> Remarks: Abutting Lot Line ft. <br /> N, S, E, W <br /> Approved By �� �""`' �) <br /> Ciry EnBincer <br /> ' G�-' <br /> issued By �� <br /> �� �`�r' <br /> Inspection By <br /> Date Inspected � ��� O� <br /> SEE SKETCH ATTACHED <br /> No. 24148 <br /> INSPECTION <br />