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� <br />everett , <br />e <br />City of Everett <br />Sewer Application and Permit <br />No. 23479 DATE _ ��4/e0 <br />ei� ioscn ri.o. s.e. <br />Service Address___ __ ___ <br />2101 Cblu�bi� <br />Billing Address__ _ ____ <br />8�r�tt, IGa. 9820� <br />City, State, 2ip <br />Owner (Mortgagorl pa�= p°�� _ <br />iaL�r fedonun <br />Billing Name_ <br />p�ul IMathand <br />Connection Hv— _— <br />��—i�Jli <br />� DESCRIPTION: <br />� Lot _ _ 6 plock <br />; p�a� Pet�rs Pla! �1 <br />IUnplatted Description <br />I TYPe Permit: rw Conn�ctla <br />CHART N0. C � � �� -s <br />Utility Account No. �5895-� <br />Permit Fee 30.00 <br />Connection Charge�s) 303.50 <br />�0.00 <br />Total Fee <br />Siyned <br />cuetomnr <br />SEE SKEICH ATTACHED <br />�6 BoM 'tII <br />Sewer District <br />S.M <br />Monthly Sewer Service_._ _ <br />Monthty Sewer Canstr. <br />Trunk �•�5 7f)2.50 <br />Lateral <br />Abutting Lot Line <br />N, S, E, 'N, <br />Approved By_ H. Nu=an <br />City Enginen <br />C. Hond <br />Issued By <br />Inspection By � '% �P�� _ <br />�/ <br />Date I nsper,ted � � ;5 'tJ __ <br />N�. 23479 <br />N <br />