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CHART NO. V 2`�"Z`i'S <br /> everett � <br /> � P�sTED �-2y-81 <br /> City of Everett � <br /> Sewer Application and Permit <br /> No. 23896 DATE �����f <br /> ; <br /> Service Address '��l t . Utility Account Na <br /> � i <br /> � � Permit Fee��� <br /> Billing Address " � '� <br /> City,State, Zip i Connection Chargels) — I <br /> ��� <br /> :��' <br /> Owner IMortgagor) Total Fse — I <br /> i/ <br /> Billing Name � � , .= :� <br /> _ _� <br /> Con�ection By.•�� <br /> Address Signed <br /> Cusiomer <br /> Phone � �� j� <br /> DESCRIPTION: Sewer District — <br /> .�--- . <br /> �ot Block 4. �. Monthly Sewer Servir,e ' <br /> Plat�— � � <br /> Unplatted Description Monthly Sewer Constr. <br /> Trunk � <br /> Type Permit: Lateral <br /> � <br /> Remarks: Abutting Lot line <br /> N, S, E, W ft. <br /> Approved By <br /> Ciry Engineer � <br /> i <br /> i <br /> ISSUEC� BY � I <br /> � . <br /> � . <br /> Inspection BY ; � �^ — <br /> Date I nspected � y� �'� �� � L `j� <br /> -- No. 2389t� <br /> SEE SKETCH ATTACHED <br /> INSPECTION <br />