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everen <br />e <br />City of Everett <br />Sewer Applicction and Permit <br />NO. 23430 DATE 1L19-79 <br />Service Address �1� ��_'° <br />Billing Address S1S 116th fi.*. Sylb 211 <br />Mll��ue, Na. 9800� <br />City, State, Zip <br />Owner (Mortgagor) p� norito <br />Billing Name $� <br />Connectio� Bv s� <br />�SS t6S0 <br />DESCRIPTION: <br />Lot 26-27 � <br />Block <br />Plat _ ai� t�nd �b. 1•�t <br />Unplatted Description _ <br />Type Permit: � aP_ off <br />Utility Account No. <br />Permit Fee �•SO <br />Connection Charge( <br />2.50 <br />Total Fee <br />Signed <br />Customer <br />SEE SKETCH ATTACHED <br />INSPECTION <br />Sewer District <br />Monthly Sewer Service <br />Monthly Sewer Constr. <br />�' O Lateral <br />Abutting Lot Line <br />N, S, E, W <br />I <br />I <br />N. Marnn ; <br />Approved By � <br />Cny Engineer <br />ssued By E' Bond I <br />nspection <br />Iate Insoe <br />rvo. 23430 <br />