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, <br /> � <br /> everett CHART NO.L ' Z�`- 2-`�'— S � <br /> � � � � � <br /> e �-�_ �- =- <br /> �_ Z _ � � ; <br /> City of Everett �,���./ + <br /> C <br /> Engineering & Community Services � <br /> Sewer A�plicc�tion �and Permit ! <br /> _ , , _, <br /> � <br /> NO. . . � •I DATE ,� - / • - � � <br /> — -- � <br /> Service Address_' ' �� � -� <br /> _ Utility Account No. <br /> Rillin� Address____ PermitFee ��- ' <br /> City, State, Zip Connection Charge�sl_ ' <br /> Owner (Mortgagor) __ ____ Total Fee_ <br /> Billing Name. _ _ i <br /> > E: <br /> � <br /> Connectior By_ '..-�-' ��___ �� _ i <br /> � , i <br /> Address --,-- Signed � / _- l� I <br /> Cusiomer r <br /> Pf10flC � <br /> DESCRIPTION: Sewer District ; <br /> _ i <br /> Lot --- Block------- <br /> Pla[ Munthly Sewer Service __ ; <br /> — --- � <br /> Unplatted Description _ Monthly Sewer Constr. i <br /> Type Permit -, v Trunk � <br /> _ __ I <br /> � <br /> _ _ Lateral_ i <br /> Remarks: - •-:. � -+-'�' • <br /> --- ..�-.t. ... ._..lr�..., i .- _ 1 <br /> Abutting Lut Line 1 <br /> ------- N, S, E, W ft. � <br /> ..^` ,y���ec . ��- <br /> / �� , i <br /> _—_�_�� • <br /> —fI�Gt ct .y � /0..'Z � .-t rs�r .-.-.-t, � <br /> � <br /> - �L�� , � � <br /> — APProved By ' d ' I <br /> - - ---- City Enpineer <br /> � <br /> —_—____ —. —.— ' ' � <br /> Issued Ey � ' �_.-;----�- <br /> - - i <br /> Inspectian By C�. •�� <br /> I <br /> a - -_ _ - - -- -----_ . Date I nspected � - �d - y � � <br /> SEE SKETCH ATTACHE.D N� <br /> � u� !'(-.(,i � <br /> F 5F"'E� �.� ����� `41�� . �-. . . � . ..„ I <br /> , �� �. . , a., 4^ . , ,'m b B.4lh•.it:=,' . _ . . _ . . . ..e_:.> , . �f: � <br /> 4, <br />