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� <br /> � everetl CHART N0. <br /> � I <br /> City of Everett I <br /> I � <br /> Sewer Application and Permit I <br /> No. 25169 DATE ���j S� � <br /> < � <br /> Service Address� Utility Account No. � <br /> Billing Address— ��/'h� _ Permit Fee_ �( J �'� � <br /> City, State, Zip � �� �� Connection Charge(s) I <br /> Owner (Mortgagor) � _ Total Fee_ y1� Q� <br /> Billing Name <br /> �� �. <br /> Connection By � 1��.� �^-d�rJ <br /> Address��a�i�_( � -_ � (�/������ � , / I <br /> Phone— ��- �p� 7 c�:�o� •- - <br /> DESCRIPT� ,.� Sewer District <br /> Lot � Block�� <br /> Plat Monthly Sewer Service <br /> Unplatted Description Monthly Sewer Constr. <br /> Type Permit: Trunk <br /> Lateral <br /> Remarks: <br /> // � Abutting Lot Line <br /> it�,_-a.e� /Y Rii- o.-,e�Hi.-i J� o N, S, E, W ft. i <br /> �l� <br /> I <br /> Approved By�� � � ' <br /> C E gmeer — '� <br /> Issued By���r.---.-�_..G_-�.,�,� i <br /> I Inspection By � ��e/sHdN , <br /> Date Inspected_ �Z- � <br /> � <br /> SEE SKETCH ATTACHED NO. 25��j9 <br /> IN;PECTION � <br /> L I <br /> � <br />