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,rverett <br />� <br />City of Everett <br />CHART NO;:—FJF' �2— 8�5 — <br />, ;; <br />... .� -� : <br />S �`��. <br />, ,, <br />� ��� <br />�I $���nr�r App�ir;ati�,�i� �nd Pe+'mit <br />rvo. 23978 <br />5�5�81 <br />DATE _—. <br />8706 9th Avenue <br />Serv�ce Address - <br />Billing Address�---- <br />City, S[ate, Lip_ -� <br />Owner lMortgagor) <br />Billing Name -�— <br />Utility Account No. <br />Permit Fee no�-- <br />Connection Chargels) <br />none <br />Total Fee <br />Connection By C.ttv o� e�t <br />Don .Miller <br />Signed Custamcr <br />Address <br />Phone <br />Sewer District <br />DESCRIPTION: <br />Lot�---- 81ock_�— Monthly Sewer Service_ <br />Plat Monthly Sewer Constr. <br />Unplatted Description_— <br />r_....�. <br />SEE SKETCH ATTACHED <br />Lateral <br />�butting Lot Line <br />N, S, E, W <br />A. R. Theal <br />�pproved BY Crty En9inecr <br />r, nond <br />I ssu ed '3y_---------�— <br />INSPECTfON <br />� ;x�-,2. �. �, / /: r:. , X .. _ <br />Inspection By' <br />r• � / <br />Date Inspected� --- <br />No. 23978 <br />i <br />, _ , <br />