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everen <br />e <br />City of Everett <br />Sewer Application and Permit <br />N0. 22��6 DATE <br />CHART N0. ��o "Z8 S <br />Service Address_ �� d� ��[t: �iP��jtility Account No.�� '� �� o�''� <br />_ .� _ _e �-. <br />a <br />Billing <br />Ciry, S <br />Owner <br />Billing <br />Connec <br />Phone_ �%� �g� <br />Permit Fee_ �f D <br />Connection Ch�rgels) �2o p _ <br />Total Fee 3C ��f <br />Si <br />DESCRIPTION: Sewer District�� �� � <br />Lot � _ Block Monthly Sewer Service a'� <br />Plat <br />Unplatted Description __ Monthly Sewer Constr. <br />Type Permit: <br />Remarks: <br />SEE SKETCH ATTACHED <br />INSP[CTION <br />i <br />Trunk �•.?� Zs ��� <br />Latera <br />Abutting Lot Line <br />N, S, E, W ft. <br />Approved ` <br />` CnY Engmeer � <br />ISSUBfJ BY <br />Inspection By�'�'� �I // <br />Dat� In;pected � c� 7" �� <br />Na. 22856 <br />