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everen <br />e <br />City of Everett <br />Sewer �4p�licction and Permit <br />No. 23196 <br />DATE 6/� � /7 <br />Service Address / 90 3 �' �' G� �����Ky Account No. -- <br />di . <br />Billing Address <br />�3p 8 � / � U� � Permit Fee �4 <br />City, State, Z' �� �' ' .� Connection Chargels} <br />�`i <br />/ � ' � - Total Fee � � <br />Owner (Mortgagor �%<-a r/�-•�� � "� ' <br />� �� � � � <br />Billing Name� ' `'� �'G � � <br />Connection By �'= �—� � • , � <br />, � -, �, <br />Address __ Signed c ��o��� � � � <br />Phone �� �' // S � _ <br />DESCRIPTION: Sewer District__ _� <br />Lot ��BIocJ `� �' Monthly Sewer Service -� ' f� `�-�� <br />� � <br />PI ,a•a -C.�-T ---�J " �- <br />Unplatted Description_ Monthly Sewer Constr. <br />SEE SKETCH ATl"ACHED <br />I!i!LITr L�IIJ_It�G <br />Laterzl <br />ing Lot Line � �_/ // <br />N S E, W�: l�- �`f ft. <br />� �'� ._,,c,,•j,-� <br />�ved By�� ��'" <br />C��V Fngnieer �� <br />n / j <br />i sv �- /.-�s-��„� _ <br />�ction <br />Inspected — <br />No. 23196 <br />-� <br />1 <br />