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We <br />City of Everett <br />Sewer Application and Permit <br />No. 23998 <br />DATE 61 <br />Service Address <br />Billing Address _,_�-V -----. <br />O <br />City, State, Zip <br />Owner (Mortgago / <br />Billing Name <br />CHART NO.i IZ'25_Cf <br />?p�ii29 10-z�-81 <br />Utility Account No.;;�6 070 r 2 <br />Permit Fee 30.66 <br />Connection Charge(s)��,,nn33�'�a <br />Total Fee�"� <br />Connection By_ <br />Signed `r" Comer <br />Address <br />Phone/3 96�0 <br />Sewer District <br />DESCRIPTION: <br />Lot <br />Block Monthly Sewer Service <br />Plat Monthly Sewer Constr. <br />Unplatted Description � �7 <br />Trun <br />k <br />SEE SKETCH ATTACHED <br />Lateral <br />Abutting Lot Line <br />N, S, E, W_ <br />c r <br />APPfOVed By emu4 p <br />Issued 8y <br />INSPECTION <br />Inspection By <br />Date Inspected <br />NO. 23998 <br />