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evereri <br />e <br />City of Everett • <br />Sewer Applicction and Permit <br />No. 23430 <br />;ervice Address <br />3illing Address <br />�ity, State, Zip <br />Jwner (Mortga <br />3illing Nama_ <br />:onr.ection By. <br />DATE 1i19-79 <br />3912 Wat�ore <br />515 116th N.t. Suite 231 <br />Bellavue, Wa. 98004 <br />Paul Fiorito <br />Same <br />Samo <br />Phone 455 4650 _ <br />DESCRIPTION: <br />Lot 26-Z� Block � <br />Plat _ Clie�a�c Lend Co. 1'st <br />Unplatted Description <br />i�ype Permit: e Cay off <br />CHART <br />Utility Account No. <br />Permit Fee 2.50 <br />Connection Charge� <br />Total Fee Z•50 <br />.' / • <br />Signed�ir: -1 �.� /; <br />c�,��o�„�� <br />SEE SKETCH ATTACHED <br />Sewer District_ _________. _ <br />Monthly Sewer Service_____ <br />Monthly Sewer Constr. <br />Trunk <br />Lateral <br />Abuttiny Lot Linc <br />N, 5, F, W ft. <br />Approved By H. Nerren <br />Cily En9meer <br />Issucd By .. E. Dond -- <br />Inspection By_ <br />Caic insoccted <br />rvo. 23430 <br />