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evereri <br />e <br />CiH of Everett <br />Sewer Application and Permit <br />N0. ���26 <br />Service <br />Billing <br />DATF <br />City,State,uP--�=� � „� /JOJ <br />// /�/,� y <br />Owner ltriortgagorl— ��'«�—`}� <br />�—_ <br />Billing'Nanie <br />CHART NO. N �S-Z'"�— <br />lity Account No. <br />' -. pl"'- — <br />Connection Charge(s) B� <br />�p _— �— <br />Total Fee <br />Connection BY � <br />Signed Cusmmcr i <br />/ <br />Address_ <br />Phone 'SS' � 9� <br />Sewer District <br />DESCRIPTION: —�� Monthly Sewer Service <br />Lot Bloc�C <br />Plat _ �=""44 // '�— Monthly Sewer Constr. <br />Unp�atted Descript�on_� Trunk <br />Type Permit: <br />Remarks: <br />SEE SKETCH ATTACHED <br />Lateral <br />qbutting Lot Line <br />N, S, E, W <br />� <br />� <br />APProved BY c.�v �9 Ce� <br />I :sued BY�" <br />_�' <br />� <br />�i � l ���'' - <br />INSP[CTION <br />No. 23926 <br />