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t <br /> CHART NO. <br /> ierctt � <br /> e <br /> City of Everett <br /> Sewer Application and Permit <br /> No. 23032 DATE <br /> o � <br /> Service Address�2� �7t� �,s�ce. _/. I�� Utility Account No. 7-�� <br /> Billing Address_ 6 Permit Fee <br /> City, State, Zip -� Connection Charge(s) y�s <br /> ` o �✓ <br /> Owner (Mortgagor) � pati-7--21e---!-Q�J Total Fee <br /> 7 <br /> Billing Name_ <br /> Connection By ""r Address------- Signed <br /> Customer <br /> Phone_ �76 —75'/3 _ <br /> DESCRIPTION: Sewer District 3r- 4:5,=� <br /> Lot BI kms— Monthly Sewer Service 1 h d <br /> Plat � A292 <br /> Z —.� <br /> Unplatted escription Monthly Srwer Constr. <br /> Trunk cy <br /> Type Permit: <br /> Lateral a •7S e?6S 0�— <br /> Remarks: <br /> Abutting Lot Line <br /> N, S, E, W ft. <br /> J011 lip 'k <br /> rs Zil i A <br /> Approved ' <br /> C y Engineer <br /> t A. Issued By--- <br /> r <br /> Inspection By-- <br /> Date Inspected — <br /> SEE SKETCH ATTACHED No. 23032 <br /> INSPECTION <br />