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everett <br />� <br />Ciry of Everett <br />EnyinPering & Community Services <br />Se�wer Application and Permit <br />NO. '. DATE LL— '- i� r <br />. T �_ <br />Service Addressl� �' r' �'' % <br />9illing Address ''�=- - < � <br />City, State, 2ip '�� ���-- � J <br />Owncr (Mortgagor�_: — _: t : �!%-�-� <br />Billing Name �"'� �-�--- <br />Connection 9y_ . .j=-2��,�__�-.— ._ <br />Address <br />i ' //�� <br />ohnnr .J " 3_ — <br />DESCRIPTION: <br />Lot� �� Black <br />Plat � L�- <br />Unplatted Description <br />' I -� ,, ' r__ <br />, CHART �JU.v -! -- _ --=- <br />� ,/ � _ — � -, <br />� J ��� .> . , `:_ - <br />� /- ���-- � ; <br />,/_�'< � ''' . <br />Utility Account No. <br />-> !i �—� <br />Permit Fee iU <br />Connection Charge�s) -'" ` . > � <br />;J=_�-�" <br />TotalFee i �J �� <br />r . <br />Signed� ��� / �6�61� <br />% usinmar <br />a <br />SEESKETCH ATTACHED <br />� ;s;�i . ;�, .'`�•. _ ,� <br />Sewer District <br />Monthly Sewer Service. <br />Monthly Sewer Cons�r, <br />Trunk_ <br />�ateral <br />A6utting Lot Line <br />N, S, E, W_ <br />0 <br />i <br />� <br />� <br />— i <br />i <br />it. � <br />I <br />. � <br />Approved By ;�� <br />Cily Enpinem <br />� � <br />I <br />Issued By —� '� � <br />Inspection By � � ��""� <br />Date Inspected � Z � <br />• e � ,,,. , <br />; <br />■ <br />