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everetl <br />e <br />City of Everett <br />Sewer Application and Permit <br />NO. 9AQd9 <br />Service <br />Billing <br />City, S <br />Owner <br />Billing Name <br />Connection B <br />DATE 42191f/ <br />Address p <br />Phone — <br />DESCRIPTION: <br />Lot 2 . Block <br />Plat — <br />Unplatted Description <br />SEE SKETCH ATTACHED <br />Utility Account No. <br />Permit Fee <br />Connection Charge(s) <br />, <br />Total Fee 30 <br />�9,i� F3 <br />be° nl' <br />Signed Customer <br />INSPECTION <br />Sewer District <br />Monthly Sewer Services <br />Monthly Sewer Constr. <br />Trunk <br />Lateral <br />Abutting Lot Line i7 ft. <br />N,S,E,W �y <br />Approved By'llef' � -- <br />C,ty Engmeer <br />Issued By <br />� P <br />Inspection 13) / � <br />Date InspectedS— <br />No. 24949 <br />z <br />0 <br />m <br />