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1 <br />-z <br />CHART NO. �� ' � ` �' ` <br />everett <br />e <br />City of Everett <br />Sewer Application and Permit <br />NO. 24236 DATE npril 7, 1982 <br />a�ia State q tNo <br />Service Address <br />Billing Address <br />City, State, 2ip <br />Owner (Mortgagor) _ <br />Billing Name — <br />City of Evoret� <br />Connection By <br />Address <br />Phone — <br />DESCRIPTION: <br />Lot _ [31ock — <br />Plat <br />Unplatted Description <br />Pos-�n <br />4 - ��i - 8z <br />C.d-� <br />utility ccoun . , <br />Permit Fee none �I <br />i <br />Connection Charge(s) � <br />none <br />Total Fee <br />I <br />I <br />i <br />uon Hillar j <br />Signed — II <br />Customrr <br />I <br />Sewer Distnct <br />N;onthly Sewer Service. <br />Montlily Sewer Constr. <br />Trunk <br />Lateral_ <br />Abutting Lot Line <br />N� S• t� W— <br />SEESKETCH ATTACHED <br />ApprovedBy n• R• Theal I <br />Ciry Engineer <br />E. 60nd I <br />Issued By - � <br />r i" � �i�;, :,, .,--- � J <br />Inspectian By — <br />Date I nspected <br />'� �-'L <br />No. 24236 i <br />INSP[CTION <br />t _.. <br />