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everett <br />I� <br />City of Everett <br />Sewer Application and Permit <br />No. 24418 DATE <br />Service Address 610 65th Place S.E. <br />Billing Address 1012 Park Drive <br />City, State, Zip Everett, Va. 90203 <br />Owner (Mortgagor)Arthur Dran3vold <br />Billing Name Arthur Brandvold <br />Connection By _ <br />353-3952 <br />DESCRIPTION <br />Lot 5 Block <br />Plat Ward Addis <br />Unplatted Description <br />Type Permit: pew Connection <br />nemarKs: <br />December 10, 1922 <br />SEE SKETCH ATTACHED <br />Utility Account No. 76221-1 <br />Permit Fee 30.00 <br />Connection Charge(s) un_nn <br />Total Fee 30.00 <br />Signed <br />Customer <br />Sewer District Bond I <br />Monthly Sewer Service 6 5D <br />Monthly Sewer Constr. <br />Lateral <br />Abutting Lot Line <br />N, S, E, W <br />Approved By A. B. The <br />a1 <br />City Enpmeer <br />Issued By E. Bond <br />Inspection By� <br />Date I nspected Z <br />No. 24418 <br />INSPECTION PosT)D V / <br />