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evereft <br />e <br />City of Everett <br />Sewer Application and P�rmit <br />�.4409 12i8�82 <br />NO. � DATE <br />Service Address 716 34th Strset <br />Billing Address <br />City, State, Zip <br />Owner (Mertgagor) <br />Billing Name <br />Connection By City of Everebi: _ <br />Address <br />DESCRIPTION: <br />Lot_ Block <br />Plat <br />Unplatted Description <br />T.._� 1'1.���:�. <br />:HART Nd. <br />f'. _ . ���„ ,��� <br />, �: � � <br />Utility Account No._ <br />Permit Fee None <br />Connection Chargels)_ <br />Nona <br />Total Fee <br />Don btillcr <br />Signed <br />Customer <br />SEE SKETCH ATTACHED <br />INSPECTION <br />Sewer District <br />Monthly Sewer Service <br />Monthiy Sewer Constr. <br />Trunk <br />Laterai <br />Abuttiny Lot Line <br />N, S, E, W <br />Approved By A. R. Theal <br />C�ry Engincer <br />I ssu ed <br />I��speciion By � � I � .11 /�, . , rr ��/�" — <br />Date Inspected i � 7— �{'� � <br />NG. 24409 <br />�l <br />� <br />J <br />