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everett <br />� <br />City of Everett <br />Sewer Application and Permit <br />No. 23279 � � � <br />Service <br />Billing , <br />City, S� <br />Owner <br />Billing <br />Connection BY ���r�D <br />CHART NO.� -3',J—�'T— <br />�s �� <br />�/i� �j <br />Nvc 9Il`bl�� � <br />� <br />DATE ���/ - <br />Utility Account No. ��d 6 6 <br />Permit Fee <br />30 0� <br />e�� <br />Connection Chargels) -2�/� <br />� <br />Tom! Fee 3 d ` <br />Address <br />Phone o�s�- �i0 7 p <br />DESCRIPTION: <br />Lot Block�:�� <br />Plat "� v <br />Unplatted Description <br />Sewer District �� ✓�'�� - <br />Monthiy Sewer Service � �s� <br />Monthly Sewer Constr. <br />� <br />Trunk ��S ��U-- <br />SEE SKETCH ATTACHED <br />+� 'i-CTIGN <br />Abutting Lo[ Line <br />N,S,E,W <br />Approved By <br />Gry Engrnccr <br />Issued <br />Inspection By �_�!� �� <br />Datelnspected � - �v �� <br />No. 23279 <br />