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CHART NO.14'' ` "- <br />everett <br />City of Everett <br />Engineering & Community Services <br />Sewer Application and Permit <br />No. 21931 DATE K z <br />Service Address <br />• <br />/-)D Z S <br />Billing Address /� 1L <br />City, State, Zip r <br />',Utility Account No. <br />Oa <br />Permit Fee <br />Connection Charge(s)_ <br />Owner (Mortgagor) - —� Total Fee — <br />Billing Name_ <br />Connection By_ <br />Signed Cu Turner <br />Address <br />Phone <br />Sewer District <br />DESCRIPTION: <br />Lot e- Blocky — Monthly Sewer Service <br />Plat 1 X C <br />Monthly Sewer Constr. <br />Unplatted Description <br />Trt: <br />Abutting L Line <br />N j E. W <br />Approved By <br />City Engineer <br />Issued BY <br />Inspection By y -0..��— <br />Date Inspected _ <br />NO. <br />