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I <br />everett <br />e <br />City of Everett <br />Sewer Application and Permit <br />No. 23498 DATE 2/15/80 <br />Service Address 3014 21st street <br />Billing Address <br />City. State, Zip -- <br />Owner (Mortgagor) -- <br />Billing Name <br />Connection By City of Everett <br />Address <br />Phone --- <br />DESCRIPTION: <br />Lot Block. <br />Plat <br />Unplatted Description <br />Type Permit: repair <br />Remarks: <br />SEE SKETCH ATTACHED <br />CHART NO. UZC'ZLS <br />Utility Account No. <br />Permit Fee none <br />Connection Charge(s) <br />Total F <br />Don trtil.ler <br />Sewer <br />Monthly Sewer Service <br />Monthly Sewer Constr. <br />Trunk_ <br />Lateral <br />Abutting Lot Line <br />N, S, E, W <br />F., warren <br />Approved By <br />City Engineer <br />F. Bond <br />issued By <br />Inspection By <br />Date Inspected —/=f <br />No. 23498 <br />t. <br />INSPECTION <br />