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CHART N0. <br /> everett i� Z/-z.5-s <br /> e � ,-� <br /> �s � <br /> City of Everett � ` 2 �P G� _ <br /> J <br /> Sewer Application and Permit �� <br /> N0. 23516 3�4�80 <br /> DATE <br /> 3611 24th StsCet <br /> Service Addre;s Utility Account No. <br /> Billing Address _ Permit Fee nO11° _ <br /> City, State, Zip Connection Charge�s)_ <br /> none <br /> Owner (Mortgagor) — __ Total Fee <br /> Billing Name <br /> Citx of everett <br /> Connection By_ <br /> Don Miller <br /> Address Signed <br /> c,�:�om�, <br /> Phone <br /> DESCRIPTION: Sewer Distric: <br /> Lot Block <br /> Plat Monthly Sewer Service <br /> Unplatted Description Monthly Sewer Constr. <br /> Type Permit: repair Trunk <br /> Lateral <br /> Remarks: <br /> Abutting Lot Line <br /> N, S, E, VJ _ft. <br /> ;�/''., K � �S Ti � � � <br /> —_� � <br /> ' . '-- -- --- R. i�.'aL2'en <br /> � . T— . Approved By <br /> �� j :�` , �_ , ,_� ,--T, City Enginecr <br /> „ /'< �_. -. . <br /> _ � �, ri. �-- /_.� .; ', ,' , i/. // <. � ., r. nond <br /> Issued 6y <br /> Inspection By � � � ' ' � �/ <br /> Date Inspected – - � <br /> SEE SKETCH ATTACHED NO. Z�J16 <br /> INSPECTION <br />