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' CHART NO.-- rc, � c' t , " <br /> k <br /> � everett ;, ;, ,.=,a <br /> E �. v z3 <br /> Ee <br /> � <br /> � City of Everett <br /> Engineering & Community Services I <br /> Sewer Application cnd Permit '' <br /> , , <br /> NO. __ '_ ;° �i �� DATE � (/� "'i -I --- <br /> ServiceAddress �"=%C i �1����� _ UtilityAccountNo._ —_.-- <br /> �v. G. 4 �7�'_ t...;�,,�� <br /> Billing Address� �`' � _ Permit Fee__ <br /> t.�f ,Z.L; �+ <br /> � City,State, 2ip �--- �/��t-7T _ Connection Charge�s) <br /> Owner (Mortgagor) -}L-tn.� ��'�''`, �.�--:L Total Fee_ �Uw-��- <br /> c:' <br /> BillingPJame �-��`�- <br /> Connection By �--��� � �-'� �--'�'r-T��-�T � <br /> Address Signed ��-��- `�-' �� �-�'��= �"� y� _— <br /> Customer <br /> Phone — <br /> F DESCRIPjION: Sewer District _ <br /> � Lot f� Biock �-� <br /> � Plat_� I �;��k�`i F'� Monthly Sewer Service <br /> Unplatted G.,scription Monthly Sewer Constr. <br /> �. ( Trunk <br /> Type Permit: `�t.,LU �„�J-f��'q,L —� — <br /> —� Lateral <br /> Remarks: <br /> — �.. Abuiting Lot Line <br /> 9 /Jctt✓'lc ��_� L�-a � �s�- N, S, E, W ft <br /> , <br /> � <br /> �s e _(, . <br /> ; ;�� , � <br /> � C�, .�...ce� in-..c� �r�v . <br /> ( �vic. s��-....a . APProved By � . �.��,.ti.!N r.« G� .-- <br /> � City Engineer <br /> � — Issued By � �-. i�'G."L_!'�*�-i>>''� _ , <br /> � <br /> t _ � <br /> � Inspection By ��'-E' '� ,✓"�-+��-+�� <br /> i� Date I nspected �—J u - I, ' <br /> 9 , -- <br /> t <br /> t SEE SKETCH ATTACHED tvG. <br /> ` „ , <br />