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everetl <br />� <br />Cit�� of Everett <br />Sewer Application and Permit <br />No. 24332 DATE _ n„ <br />ServiceAddress q,�3=��r <br />Billing Address ����_a��Fq�j�y,�,i����_ <br />City, State, Zip�zr,.oeT� Np c�q��� <br />Owner �Mortgagor��S_�ygq�g <br />Billing Name �q� <br />Connection By n......., _ <br />Address _ <br />Phone �55—A-'.92 — <br />DESCRIPTION: <br />Lot��n; Block <br />Plat �� <br />!Jnplatted Description <br />Type Perrnit: <br />--�ri�,- <br />n,._....�.. <br />I CHART <br />Utility Account No.�63$p_n _ <br />Permit Fee �grpn _ <br />Connection Chargc�sl�j�— _ <br />Total Fee <br />Si <br />SEE SKETCN ATTACHED <br />INSPFCTION <br />Sewer District_ <br />Monthly Sewer Service (�n <br />Mantfily Sewer Constr. <br />Trunk � ]5 Z)p�pp— <br />La[eral <br />Abutting Lot Line <br />N, S, E, W tt. <br />Approved By _ <br />n er <br />ISSue(1 ��' _—�fEdl'tfM�iB'RfMir— <br />i <br />Inspection 8y ''� � � ' -���� �S� ' <br />Date Im;pected `1 � �� F'��`�' � �� <br />No. 24332 � <br />� <br />_f <br />