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everett <br />� <br />City of Everett <br />Sewer Application and Permit <br />No. 24342 DATE ��y= 3�}q� <br />Service Address._��_ _ .74th_sK-- <br />Billing Address�p�_st_fYE1,GLt_1�71_Nif�_ <br />City, State, Zip_.�,�r_��__�Q�'_. <br />O�vner IMortgagorl.��s_� <br />B Iliny Name <br />C�rniection By_S��_ <br />Add�ess <br />Phone ��r�.-_ <br />DESCRIPTION: <br />L�t�__ Block _ <br />P at --VBI'alen4--€Si3Lei - <br />Unplatted Description __ <br />Tvpe PermiC <br />Remarks: <br />SEE SKETCH ATTACHED <br />Uulity Account No. <br />Permit Fee_��� <br />Connr.ction Chargels) ��A e� <br />Total Fee_ � ��� <br />Signed <br />I�ISPI.CT:(�N <br />Sewcr District_���;_ <br />Monthly Sewer <br />Monthly Sewer Constr. <br />Tru nk <br />�'r5f1----?iR� Bfl— <br />Lateral ' <br />Abutting Lo[ Line <br />N, S, E, W, <br />l�pproved By ' <br />�� � �, I <br />Issued By ��a�_ ; <br />�� / <br />Inspection By � � —� <br />Date Inspected /�' "'l> — /i� � i I <br />rvo. 24342 ; <br />