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everett <br />� <br />City cf Everett <br />Sewer Application and Perrr�it <br />No. 23257 DATE � i� � I <br />ir-ii' <br />CHART NO.�] _3—"1.�6^ � <br />Service Address �/U �� ���� Utility Account No.���� �% <br />Billing Address �?rJ� %z `f �l � Permit Fee 3�� U� <br />City, State, Zip <br />Owner <br />Billing Name. <br />Connection B <br />Address_ <br />Phone__ <br />DESCRIPTION: <br />Lot��7�- B�I k J/� <br />Plat _��-f_ �C� ,!",ta�--.� <br />Unplatted �escription <br />Type Permit: <br />a J <br />'J Connection Charge(s) 3��0 _ <br />� �� <br />�- Total Fee _ _ > <br />Signed <br />SEE SKETCH ATTACHED <br />;N;,i't::i; t I!.-ir; <br />Sewer Disirict � �_ �.�7w� <br />Mon[hly Sewer Service__ �� SCJ <br />Mcnthly Sewer Constr. <br />Latera! <br />Abutting Lot I_ine <br />�J S, E, 'N. <br />Approvecl By=�. /��1.L1ti'--r <br />C��nginccr <br />Issued By�•���/,�%G`�� _ <br />� �. <br />� L <br />�, , <br />Inspection By � ��'/`LQ» �' <br />Date Inspected_/ " ��� � ?� <br />�o. 232�7 <br />