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CHART <br />eve <br />el <br />City of Everett <br />Sewer Application and Permit <br />No. 23249 DATE /—%------ <br />Service Address <br />,/ Utility Account No._ <br />���---�--- <br />Permit Fee <br />Billing Address <br />Connection Charge(s <br />City, State, Zip <br />Total Fee <br />Owner (Mortgagor) <br />Billing Name <br />Connection By <br />Signed <br />Phone <br />DESCRIPTION: 3 <br />Lot Block <br />Plat <br />Unplatted Desc, �ntion <br />SEE SKETCH ATTACHED <br />PosiE� <br />Sewer District <br />Monthly Sewer Service. <br />Monthly Sewer Constr. <br />Trunk <br />INSPECTION <br />4butting Lot Line <br />N, S, E, W <br />Approved By Oity Engineer <br />Issued <br />Inspection By <br />� <br />Date Inspected <br />No. 23249 <br />