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CHART NO._ <br />neo.. <br />City of Everett <br />Sewer Application acid Permit <br />No. 25010 DAIE/— <br />�� Utility Account No �'G- <br />Service Address��1—__Spe <br />�. �G*� Permit Fee_ <br />Billing Address ��� / <br />q�a0 S/ Connection Charge(s) 3 3 D -- -- <br />City, State, Zip r <br />(� � �..C�--mil Utai Fee—._-+L"----�__ <br />Owner (Mortgagor) a vt //� <br />8-0 or <br />fill - <br />Billing Name_ <br />Connection By_ <br />3s3- Phone-- <br />Or-0 <br />DESCRIPj)ON: <br />Lot j Block, <br />Plat <br />// �tu✓ <br />Unplatted Description <br />SEE SKETCH ATTACHED <br />Signed_- c�sta,ner. <br />D't <br />Sewer District <br />Monthly Sewer Service__ G S� <br />Monthly Sewer Constr. <br />Trunk--� <br />Lateral <br />Abutting Lot Line <br />N, S, E, W <br />Approved <br />CIV Enpmex <br />Issued <br />INSPECI ION <br />Inspet <br />Date I <br />No. 25010 <br />0 <br />m <br />