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R <br />a <br />everett <br />i <br />i <br />i <br />City of Everett <br />Sewer �4pplic�tion cand Permit <br />, No 2311� -�� <br />CHAflT N0.___ <br />��,_ � ' ( ._ oi .I _ S. <br />�� � J ^� <br />/�- � <br />I • DA7E � � <br />. <br />I �_� � ----�"-. <br />Service Address � Utility Account No. <br />I <br />j Billing Address_ Permit Fee <br />ICity, State, Zip Connection Chargel <br />i Owner (Mor[gagor) <br />Total Fee___ <br />� <br />, Billing Name <br />I Connection By_ <br />� DESCRIPTION: <br />' Lot <br />Plat __ <br />Unplatted Descr <br />Type Permit: <br />Block <br />Signed � <br />SEESKETCH ATTACHED <br />Sewer District <br />Monthly Sewer Service <br />Monthly Sewer Constr. <br />Trunk <br />Lateral <br />Abut[iny Lot Line <br />N, S, E, W_ <br />Approved By _ <br />Cny Engmcer <br />Issued B <br />Inspection By %�% �< <. �1.��: ,�c L. <br />Date Inspected_ �.� ^ - 7 � <br />-- . _ _ <br />No. 2311°� <br />