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everen <br />� <br />City of Everett <br />Sewer Application and Permit <br />r�o. 24379 <br />Service Address �(,L� �.�� ' Utility Account No._ <br />BillingAddress_�'Yd � ��T.L_�_ permitFee,�� <br />City, State, Zip ��=��,L_ ��03 Connection Charc�elsl_ <br />Owner (Mortgagor�—��GGC�--��������tal Fee___�1j _ <br />Hilling Name_� ���������/'�� <br />Connection By �_� �,�.fe�s����' <br />� <br />Addres, <br />Phone._ _ .33�- ��� ____ <br />DESCRIPTION: <br />Lot Block 3 �L � <br />Plat .� i�,�.����—�L ��as(�O� <br />Un�latted Description <br />0�.�' <br />0 <br />Signed <br />Cultomer <br />Sewer District <br />Monthly Sewer Service.___ <br />Monthly Sewer Constr. <br />Trunk <br />�ateral <br />butiing Lot Line <br />N, S, E, W <br />SEE SKETCH ATTA�HED <br />IrI6Pi�C t �l,N <br />aproveo By �c.r J <br />cnv �„c� <br />o �� ' <br />�ued 5y._ _�,�. <br />cpection By— ' /� �! r /�'"d.. <br />[e Inspected.__ • � 'cr��' <br />N�. 24379 <br />1 <br />J <br />