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CHART N0. L � G ` ��-s <br /> evereri � <br /> � � �Tc=i� <br /> � � _ <br /> � r� (��J <br /> City of Everett ��i <br /> L�, <br /> Sewer Applicati4n and Permit <br /> N0. Z3344 DATE /�� !- [_ _ ..� _ <br />' , 1 , _ <br /> I Service Address� � �Z�' Utility Account No. <br /> � 0i <br /> Billing Address � Permit Fee <br /> City,State, Zip ' Connection Chargels) <br /> ` <br />� �� � r' �- � <br /> Owner (Mortgago� is..n� -ry••.�->`G Total Fee__J � U <br /> I <br /> Billin Name <br /> 9 <br /> Connection By `'��n��t- �1� /1��v� <br /> Address ��� � ����-_� �a'f' Signed -- <br /> p ,/ Customer <br /> Phone <br /> 1�'.J�J' O �`T�' . <br /> I DESCRIPTION: Sewer District <br /> Lot�/ �l ��- Block 3`\ �, Manthly Sewer Service <br /> Plat ��c.�-e'� -i-�� l� <br />, Unplatted Description Monthly Sewer Constr. <br /> Trunk <br /> II Type Permit: <br /> Lateral <br /> Remarks: <br /> _ Abutting Lot Line <br /> l.r � � N, S, E, W ft. <br /> - Approved By I <br /> City Enginccr <br /> Issued By <br /> Inspection By <br /> ���{.�!`"� �% <br /> Datelnspected <br /> �� - ; � , � <br /> SEE SKETCH ATTACHED No. 23344 <br /> INSPECTIUN <br />