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�� � <br /> CHART NO. <br /> everett <br /> e - � <br /> �. <br /> .,� ,, <br /> , ; <br /> City of Everett � '/.,�,� � � <br /> y_t�i � �� <br /> l,. f .�f; ,- <br /> Sewer Application and Permit ��` � � ' <br /> N0. Z4764 DATE ��.Z 3 ,1�� <br /> Service Address��/ �___���� Utility Account No. <br /> 4%" <br /> Billing Address Permit Fee ��'U <br /> City,State, Zip .z�� Connection Chargels) <br /> o� <br /> Owner (Mortgagor _ Total Fee �d ` <br /> ' -�°�s�r*-t�+'✓ <br /> Billing Name <br /> Connection By ���-E--� ��/- � �'�*� - <br /> � <br /> Address Signed_ <br /> Cus�omer <br /> Phone -��-�� 9� <br /> DESCRIPTION: Sewer District <br /> Lot 3-� Block 3S/ <br /> � � y M Monthly Sewer Service <br /> Plat �s�• -�� <br /> Unplatted Description Monthly Sewer Constr. <br /> — Trunk <br /> Type Permit: �� <br /> Lateral <br /> Remarks: <br /> Abutting Lat Line <br /> N, S, E, W ft. <br /> Approved By_[�( - ,%� - (!!•� <br /> City Engineer <br /> Issued 8y � ��� <br /> _ Inspection�,�'� �- ` /�gH I <br /> Date Inspected �v '�z,7 <br /> SEE SKETCH ATTACHED N0. 24764 <br /> IINSPECTION <br /> �i <br /> . � <br />