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everett <br />City of Everett <br />CHART �NO. I II - <br />K3q <br />Sewer Application <br />and Permit <br />NO. 23087 DATE <br />� <br />�-� <br />Service Address o21 /il/r <br />t^l� • Utility 4ccount No. --- <br />Billing Address_' <br />Permit Fee ---- <br />City, State, Zip_ <br />Connection Charges) <br />Owner (Mortgagor)_ <br />Totaf Fee <br />Billing Name <br />Connection By <br />Address <br />Sipped <br />Customer <br />Phone -_ / <br />DESCRIPTION: <br />Sewer District__ <br />Loth _ Block_ <br />Plat _ _- <br />Monthly Sewer Service. <br />Unplatted Description-----_ <br />Monthly Sewer Constr. <br />Trunk <br />Type Permit: <br />_ <br />Lateral <br />Remarks: <br />— - <br />Abutting Lot Line <br />- <br />N, S, E, W_ <br />- - <br />Approved By <br />-—-— --— — t� <br />_ <br />Cary <br />Issued By <br />SEE SKETCH ATTACHED <br />Inspection <br />Date Insne <br />- .;;t 1—S <br />/S -< 3 <br />No. 230P7 <br />L <br />INSPFCfION . <br />