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everett <br />� <br />City of Everett <br />�vrnrer �pplicatioro �rt��� R�rmit <br />rvo. 2433� <br />DATE <br />„ , •�. <br />Service Address �?����Tz ���T�. — <br />Bil�ing Address �_,?����t� „ <br />City, State, Zip��Te���{prgg,2�4 <br />Owner (Mortgagor)��sn ��� <br />13illing Name r <br />Connection By g�= <br />Phone �yy�;qg <br />DESCRIPTION: <br />Lot_j,�__ Block <br />Plat � <br />Unplatted Description <br />T�...o Pormir• <br />CHART NO <br />Utility Account No. <br />Permit Fee__75�� <br />Connection Charge�s) ��� <br />Total Fee on nn <br />Siqned_ <br />Sewer District_ <br />SEE SKETCH ATTACHED <br />RvSFL"CTION <br />Mon[hly Sewei Service <br />Monthly Sewer Constr. <br />Trunk , ,� _ ��� �� <br />. ., z� ..�., <br />Abutting Lot Line <br />N, S, E, W. <br />ApFfoved By <br />G � Ei inccr <br />Issued By��� �� ;g��a�-- <br />1 <br />Inspection By / 1C., '-�.��'" " �''; 14',t. <br />Date Inspected_ �%^ Z�' � `�'�� <br />No. 24338 <br />1 <br />