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everetl <br />� <br />City of Everett <br />Sewer Applicati�an and Permit <br />izn9r9 <br />No. 234?9 DATE <br />)920 1MLwz� <br />Service Address <br />515 116th 1f.E. Suile ]�1 <br />Billing Address <br />City, State, ZiP �llNa� Na. 9800� <br />Owner (Mortgagor) $�1 Florito 51 <br />law� <br />Billing Name <br />Connection By a� <br />Address <br />�SS a05� <br />DESCRIZ� 141Y: <br />Lot j� Block � <br />Plat Cllwc fanA Co.• lut <br />Unplatted Description <br />Utility Account No. <br />2.50 <br />Permit Fee — _ <br />Connection Chargels) <br />2.50 <br />Total Fee — <br />Signed__ <br />cusromer <br />Sewer District <br />Monthly Sewer Service. <br />Monthly Sewer Constr. <br />Trunk <br />SEE SKETCH ATTAC4ED <br />INSPECTION <br />L7 <br />\butting Lot Line <br />N, S. E, W <br />H. Marton <br />�pproved By <br />City Engineer <br />II. Doad <br />ssued By <br />nspection <br />late Inspe <br />No. 23429 <br />u <br />