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everett <br />e <br />City of Everett <br />Sewer Applicat�on �nd Permit <br />CHART <br />P�s��� <br />No. 24293 DATE �� OZ—" � <br />Service Address�Q�—�y��2�+��"-�:�/�tility Account No._ <br />%-��-�'Z <br />c�-- <br />y� /�- �,„ a`_ <br />Billing Address k�1 Q a��,�r� . Permit Fee /�/ ` — <br />✓ <br />City, State, Zip--� 1��- Connection Charge(s) <br />/ �� ..- <br />Owner (Mortyagor�_ i Total Fee �p <br />Billing Name �v--�}— <br />Connec[ion By Y �2�?��L/ Y�� <br />if.G <br />�� <br />Address_G? %/2� � 6d- � • Siyned <br />.�y—� � C uitomer <br />Phone <br />�rt•�'� ' o- • G9 <br />�/7�j ,�/ <br />DESCRIPTION:-v-�//` ��' �a�/�O SewerDistrict__ <br />8//�/�' �. <br />Lot Block_— Monthly S'Ner Service — <br />Plat <br />Unplatted Descri�tiun <br />SEE SKETCH ATTACHED <br />INtiP�C110k <br />Monthly Sewer Constr. <br />Tri <br />Abutting Lot Line <br />N, S, E, W <br />App�oVed BY �City ngi�ee��� <br />C L� <br />Issired By �— <br />�/. ' <br />Inspection By �/"`- �� /2 '' C s� i <br />Date Inspected G?=� �C� z <br />No. 2�293 <br />