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CHART NO <br />W <br />City of Everett <br />Sewer Application and Permit <br />Cil <br />N0. 24334 DATE 1 <br />Service Address _ I11 Uk'T Utility Account No._ <br />Billing Address Permit Fee None <br />City, State, Zip <br />Connection Charge(s) <br />Owner (Mortgagor) — _ Total Fee <br />Billing NameeZverat <br />Connection By_C.it*_af—SYtratt----- -- -- <br />Address — _- _. Signed <br />Phone ---- <br />DESCRIPTION: Sewer District — <br />Lot Block Monthly Sewer Service <br />Plat — <br />Unplatted Description __ Monthly Sewer Constr. <br />Type Permit: oe"gp_—__ <br />Remarks: <br />7 <br />SEE SKETCH ATTACHED <br />Lateral <br />Abutting Lot Line <br />N,S,E,W <br />INSPECTION <br />Approved By --A} <br />incer <br />Issued By —rxyzy <br />Inspection By - — -- <br />i <br />Date Inspected---, <br />-- <br />N0. 24334 <br />