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D <br />City of Everett <br />Engineering & Community Services <br />Sewer Application and Permit <br />NO. ! DATE 11; `111ZY <br />707 <br />Service Address <br />Billing Address Lt. U L 1 (' I r` l\.'t- KJ' E- <br />City, State, Zip I`n r \,\_, T :.V t (-t.-L `J i : z 7 1. <br />Owner (Mortgagor) k T Co _ <br />Billing Name t •T Ly <br />Connection By (r/ Co <br />Address lO 1T',-L 14l— N. f- <br />Phone CP25 - _1-U, I <br />CHART N0. e _ <br />u-(OW" so, <br />ps of T6r4G <br />s'•�i.2 - 7 I' <br />/Z <br />Utility Account No. "2(1 - t Ekt—;, - C)(� <br />Permit Fee <br />Connection Charge(s) I UU < <br />UU <br />Total Fee >.(-) <br />Signed <br />! Customer ,/ <br />DESCRIPTION: Sewer District C% ��Odj(3 <br />Lot t ' Block - <br />plat �:;,C-1 %-L--r-t. - ham•>, Monthly Sewer Service <br />Unplatted Dnscription Monthly Sewer Constr. <br />Permit: <br />Remarks: <br />/AMR _,ri <br />SEE SKETCH ATTACHED <br />Trunk U Z L) <br />Lateral <br />Abutting Lot Line _ <br />N,(a E, W � -� h. <br />roved By i_ I I�_ti r.1 r t, 4 <br />Gty Engineer <br />.d By,' <br />ection By. LGCet . <br />Inspected'3 z-�; % 7 <br />