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evereri <br />� <br />City of Everett <br />S�vver Appliccation and Permit <br />No. 24337 <br />DATE <br />� + <br />Service Address <br />Billing Address . <br />City, State, Zip <br />Owner (Mortgagor)�t��� ___ <br />Billing Name _ <br />Connection By <br />Phone <br />Utility Account No. <br />Permit Fee��� <br />Connection Charge�s)��___ <br />Total Fee _ <br />Signed ' <br />Cusiamer <br />DESCRIPTION: Sewer District <br />Lot ?n _ _ Block <br />Plat �� �tt�� Monthly Sewer Se: rice_� <br />Unplatted Description Monthly Sewer Constr. <br />Type Permit: <br />SEESKETCH ATTACHED <br />ii��lSPFCTIUId <br />Trunk <br />Lateral <br />Abutting Lot Line <br />N, S, E, W <br />Approved B������ <br />gineer <br />ir.iiiisr <br />�r�i� rs• �+� u �ao r• uur�e <br />�,% �i <br />Inspection By � � —� �%�����y"� <br />- ' I <br />Date Inspected %� �� `'� F'� — <br />No. 24337 <br />