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everett � <br />� <br />City o' Eve <br />�rll,�� <br />lli� ; .-- <br />JU:d 2 t 1�3'�3 <br />rett _... ._ _ ... _ <br />E�gineering & Community Services CITY OF EVEFETf <br />Engineerin� beiif: <br />Sewer ,'�pp�i�ation and Permit <br />NO. ,� �' � il J <br />DATE C�' �� - :� <br />. <br />Service Address'��� , fi-^` <br />�> .-- � � <br />Billingqddress��-�'��� ; {��F � �i ,,�Y <br />City, State, Zip C(�.'-y,.�,,;�- L,V� j <br />�C ZU/ <br />Owner (Mortgagor) ��� { �/� ti <br />/C�TGtL�_, <br />Billing Name `'� R�,�,J� <br />Connection By_G.(1�; �c.)r � <br />�7 �n.rL <br />Address t"� �i. ��> Z-�� <br />Phone�JL _a �j_ CI `�c� C� <br />DESCRIPTION: <br />Lot �- 7' �-� <br />� —�—. Block J� <br />Plat �U�ZL, - <br />Unplatted Descrip�ion <br />�' <br />Utility Account ��o. <br />Permit <br />CHART NO.�I�%cZ . Q �. C" <br />�rl� r�� <br />7/�;�/ 8` <br />d • �V <br />Connaction Charge(s) <br />Total F�e_ �� C.> V u <br />: <br />Signed ���,�f�� ' <br />f <br />C SIOrtIP! `_' � <br />SEESKETCH ATTACHED <br />-� _ _ INt;I`ECTION <br />SewerDistrict f'-,GiZi'7-+t,✓r-� <br />Monthly Sewer Service �t j�tiZLY-� I <br />i <br />Monthly Sewer Constr. � <br />� <br />Lateral <br />Abutting Lot Line <br />N, S, E, W. <br />�PP�oved BY `- � 1(_ iJ iU <br />� <br />CitY Engineer ��� <br />;sued ey— � ��� L.�_ /J f.�x1..rL/ <br />spection By <br />ce �nspected_G -� _7 = <br />N0. : � I <br />. .. S�l.�, ...�':7Ca �"f��: t9 ut'�;Wz�altg''•y� � <br />1 <br />