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everett <br />e <br />City of Everett <br />Sewer Applicction and Permit <br />No. 23466 DATE 1/22/80 <br />���4 �t <br />Service Address <br />Billing Address __ <br />City, State, Zip <br />Owner (Mortgagor) <br />Billing Name <br />Connection �y City of �erett <br />Address _ <br />Phone — <br />DESCRIPTION: <br />Lot Block <br />Plat <br />Unplatted Description <br />Type Permit: �Pair <br />CHART N0. v �� � � •? , •- <br />1 <br />Utility Account No. <br />Permit Fee °One <br />Connection Charael <br />Totai Fee °Of1B <br />Don Miller <br />Signed <br />SEESKETCH ATTACHED <br />INSP[CTIUN <br />f 6S i E p 3�2a� �30 <br />Sewer District__ <br />Monthly Sewer Service <br />Monthly Sewer Constr. <br />Trunk <br />Lateral <br />Abutting Lot Line <br />N,S,E,W <br />Approved <br />155ued <br />�Z J <br />�r. ;rarren <br />City Engut <br />F.. Pond <br />i _ <br />I�spection By '� � <br />Date Inspected � - "/' <br />rvo. 2346 F <br />