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everett <br />e <br />City of Ewntt <br />Sewer Application and Permit <br />NO. 22892 DATE <br />Service Address r _ <br />Utility Account No. <br />Billing Address 5731 1S3rd P1&ca 6TM. Permit Fee 2•50 <br />City, State, Zip_m&n=Wa 3RM= 99020 Connection Charge(s) _ <br />Owner (Mortgagor)__Corald H. Ky" 2.50 <br />__ Total Fee <br />Billing Name Gerald Coal, <br />7 <br />Connection By Cwrald Cboat. <br />3rd Place s.M. Sd•ooda !'0020 ' Address 5731 15Signed ' to q <br />customer <br />Phone 743-5891 <br />DESCRIPTION: Sewer District __ <br />Lot 22-23 Block ' -- <br />Plat rciGWill rims Md. Monthly Sewer Set vice_.___ <br />Unplatted Description Monthly Sewer Constr. <br />Type Permit: cap -off <br />Remarks: <br />Lateral <br />Abutting Lot Line <br />N, S, E, W___ <br />Approved By L'1°iA9 <br />COY c.gmrer <br />F. Bond <br />Issued <br />Inspection By__._ <br />Date Inspected__ <br />SEE SKETCH ATTACHED <br />NO. 22892 <br />