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CHARTNO. �, L� � � 7- ��� 'S <br /> everetl <br /> ��_ <br /> e �- � <br /> City of Everett � + /� �7 � <br /> Sewer Application and P�rmit <br /> No. 23283 DATE // �!7� <br /> Service Address� %r� � - ` Utility Account No. — <br /> Billing Address _ Permit Fee -�---'— <br /> City, State, Zip Connection Chargels) <br /> Owner (Mortgagor) Total Fee ^ _ - <br /> Billing Name <br /> Connection By - �� r- -' � <br /> Address I 1 Signed __ ���� f�-� <br /> Cu�Jomer � <br /> Phone <br /> DESCRIPTION: Sewer District___ ____ __— <br /> Lot_ Block <br /> Monthly Sewer Servi;e__ _ -- <br /> Plat <br /> Unplatted Description Monthly Sewer Constr. �i <br /> Trunk _ <br /> Type Permit: -� <br /> Lateral _ __ I <br /> Remarks: <br /> Abutting Lot Line <br /> N. S, E, 1N __ ----- ft. <br /> f r<�r /,eo,;, ;»,s/ ,<, /��h' <br /> � , Approved f3y — - <br /> ���.�i� C�ty Engmce� <br /> ISSUC(� BY__ " <br /> �SC- /7GNCC- c� i'Q � �G'N . —_ <br /> / i= �c c n'� C "' �'�s'� <br /> i�,5i���ua„ �v-- ' -- - <br /> Daie Inspected <br /> ��'�- '�'i�i <br /> SEE SKETCH ATTACHED N�. G�283, <br /> IIJSPGC I ��N <br />