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everett <br />City of Everett <br />Sewer ,Application and Permit <br />NO. 24357�" ,,,, pp DATE 9j/ <br />Service Ad, lress_@jQ_Z_ . Utility Account No. <br />Billing <br />City, S <br />Owner <br />Billing <br />Connection <br />Phone 3�17- `i7$17 <br />DESCRIPTION: <br />Lot _ Block <br />Plat "to ZL/-- d'16� <br />Unplatted Dsscription <br />Permit: <br />Remarks: <br />L <br />SEE SKETCH ATTACHED <br />30� <br />Permit Fee <br />i <br />Conrection Charge(s)�d <br />Q <br />Total Fee 30 <br />Signed <br />Sewer District <br />Monthly Sewer Service • 5D — <br />Monthly Sewer Constr. <br />Trunk c f /O <br />Lateral <br />Abutting Lot Line <br />N, S, E, W. <br />r <br />Approved By <br />arv/Eogmom <br />Issued By ^ • r <br />Inspection By <br />Date Inspected i e <br />INSPECTION p061M <br />No. 24357 <br />06i,4 <br />.-I <br />