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: .. , I CHART NO.� �����/�� <br /> ; everett <br /> � i �o f�c�.� <br /> I �,/ — /,�— 7 S� <br /> / <br /> � City of Everett J ' , - <br /> � �PhIY <br /> I Engineering & Community Services � /�� � <br /> I <br /> � Sewer Application and Permit � <br /> � <br /> , <br /> i <br /> � �i0. �' ���� DATE !` `,1 // _ � <br /> _ r ' i � . . . _ ._ -- --� --_. _ . . <br /> IService Address �l�� � ��%���� � _ Uiihty Acwunt No. i <br /> � 6illingAddress ��l'r� l'��� ��- Permit Fee__ �� /(�� 'G <br /> ( City, State, Zip_ �- C f.--•t'��JT �) l� � Connection Charge�sl_. _. <br /> i <br /> � Owner (Mortgagor) _ Total Fec__ __ _' �� �� '� <br /> i �-- — -.. _----__-------- <br /> Billing Name _ <br /> Connection By �./� � ` C. ��'r"� L- �,C._.P t./7.. --- <br /> �' c;nruin�., ��, ���/� , <br /> Address--- Siqned---/ `_-/( - / / ( , --/ __ _ - — <br /> ( Phone _. <br /> IDESCFIPTION: Sewcr District <br /> � Lot_ Block____._ <br /> Plat ---------- <br /> Monthly Sewer Service__ __ <br /> Unplatted Description ___ Monthly Sewer Constr. <br /> Type Permit: �� j�� Trunk T_ _ I <br /> � � � . <br /> Lateral_ � <br /> � �� <br /> Remarks: ��4- �t.c-t�`� � .S. <br /> � � -S �T-��C y � �,n� /� Abutting Lot Line � <br /> ✓. -,!�Y C/ � ��J N, S, E, W ft. ,� <br /> I �/J� y �c w .e �GLt'L7- _ .C-�C� . — .i <br /> � --- <br /> I <br /> � '___-- � �f <br /> ; Approved By l <br /> ---- -- <br /> Gty Enq�neer <br /> Issued By L_ ( /,( L fJ//.'--- --- <br /> I ' <br /> ; � <br /> ! Inspection BY---;___., � � � �d _-. <br /> � — — Date I nsper.ted / - `' �^ <br /> � _ ,' �; <br /> , p —--� ---�---� -� -�---- <br /> SEE SKETCH ATTACHED N0. <br /> � , � .:.�� ,_ �.� �..�,�n��< rs <br /> ��9h�r�, s�aq <br /> -;.. �. �.; <br /> , trk . , �n,. :�Fa.,. . , .r��ae �.r"'i•,.� <br />