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i <br /> ' ^ � � <br /> _ � r CHART N0. V i��a�Zq� ,7 <br /> everett : <br /> �" � 5 �-'�� i � <br /> e ., ; � <br /> , � e _ �t -- � S� , <br /> City of Everett /I��� � <br />� <br /> E�igineering & Community Services ? � <br />' Sewer A�p�itation and Permit , <br /> � <br /> _, _ � <br /> N0. �' ;_ ' ��,' i� DATE ��L� ' � ' �� � <br /> s ' � <br /> Service Address ���� �--->'� � : �r ,- .�-- Utility Account No. � <br /> Billing Address / Permit Fee_ j <br /> ! ��/ - <br /> City, State, Zip Connection Charge(s) �— � <br /> Owner (:Jlortgagor) Total Fee �% _ I <br /> Billing Name I <br /> 1 . '�-� (�` I <br /> Connection By_ '� <;-'t�- �-!� ' :- �� � <br /> Address <br /> � Signed " '� , , <br /> ' usromer <br /> Phone <br /> DESCRIPTION: Sewer District <br /> Lot Block � <br /> Plat Monthiy Sewer Service 1 <br /> I <br /> ; <br /> Unplatted Description Monthly Se�ver Constr. , <br /> � <br /> rYPe Permit: :—�T - _ � Tn;:ik I <br /> Lateral <br /> Remarks: � <br /> - Abutting Lot Line <br /> __ _ N, S, E, W ft. <br /> .�,� 5p ' S. .��,., ��.o�-n- � _ ; <br /> r�� <br /> .�,�..e-o.j- rn . N. �.,1- i.n G,�--0.er.�i,o-.•� _" /i <br /> � ��� /7.�.�/ ^� A(l(]fOVB(J By; ' i:itV Engineer <br /> GI� <br /> � /� � <br /> issued By � y,.�_� I <br /> � <br /> � <br /> Inspection By�� � <br /> __ pate Inspected � �� _y " � �� � <br /> 0 <br /> � <br /> SEE SKETCH ATTACHED �'O. '' ._, T I <br /> IN�P[Cl IO��J <br /> �n .... � x , ... > ._ �_ _ <br />