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everett <br />� <br />�ity uf Everett <br />Sewer Ap�lication and Permit <br />No. 23594 DATE ����Z_ <br />�. �� ' <br />� <br />Service Address��.�( Gi % � � <br />CHART N0.- ' ' - ' <br />l�asl � S-`�-g0 <br />----�--�=•-��� '� Utiii�y Account No._ <br />/ � —��— <br />Billing Address�..7.� <- `� ��J Permit Fee__/�% r <br />`-e _�L�-�_ � � — <br />City, State, Zip_�jt �.�� __ Connection Charqels) <br />Owne; <br />Billing Name <br />Connection By '��- � _r l <br />Addrr.ss ^ ����� <br />Phone 3 • -S __.fY���- --- <br />DFSCRIPTION: <br />Lot ��� ' �/ <br />---�_ �Block----_-_-- <br />Plat �.<_- .., <br />�--i-��___.L�- - � <br />i - <br />Unplatted D scription__ <br />Type Permit �rj'--� � - � <br />-L� --+4�C�.L1`-'�-:L ..—_—.. <br />kemarks: "�.J , <br />J f.,Z �s <br />`,i- cYi.,� r �� <br />o�--- <br />Total Fee_�1 =_ _ <br />Sign <br />b� cl�c'�-_�_�-'.. _L�i„�s—ct--�- '�'�U�. �--- <br />—�.� �-,. -� 1� ' . <br />� �ki<-._{_c��\,_� �e,� <br />J_ � _--- - <br />-------- - - '.�� � <br />--- -�->---- <br />------- '' 3_,�� � ;.;.; <br />--�-_t;; = : , ._ � �- --- <br />.1 <br />_ � � � , . ---j� s��—•: J ---- <br />` i'�_.. _J-1 ,J�;�\. . <br />\ 1 <br />- �� J - �• �'..�1'��.i <br />y„ ��.��.,, <br />—=' , <br />� ,. , i, ;i „ ----; <br />_ _ ----- <br />-- ---- <br />SEE ;KETCH ATTACHED <br />uID <br />Sewer DisU ict <br />Monthly Sewer Scrvir,e__ ___ _ <br />Mon[hly Sewer Constr. <br />Trunk--------- <br />Lateral <br />Abuttinq Lot Line <br />N S, E, W---- - <br />__ ft. <br />, <br />APproved E3y �° '� ��cr-.c ft>-�� <br />Ctly Enginecr <br />� � / � <br />�SSL'Cf� QY_�'�i - C�_-�t+i. _ �.. <br />- - —� -- <br />/ � � // <br />--- Inspectio�g�✓/�C-='' ����`r �— <br />_ __�Date Inspected�'� -�+ `p'C� <br />No. 235�4 <br />�, <br />