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^ CHART NO. <br /> everett I <br /> , �/��� i <br /> e �GW_ <br /> ��, � � � ; � <br /> City of Everett ��,�1 ���� a �j - S <br /> l I <br /> Sewer Application and Permit ,_ � <br /> No. 23848 DATE <br /> ��/,,� �� '� <br /> Service Address ��� �� ✓ � 2�� Utility Account No. � <br /> .rt! - i�„ l�-1.. Permit Fee �" — — <br /> Billing Address � � <br /> � �a �/�N (f�'yy'`_ Connection Charge�s) � <br /> City,State, Zip, S� <br /> � i <br /> Total Fee I <br /> Owner (Mortgagor) '— I <br /> � <br /> Billing Name ''iyz� -- � � � <br /> —� ,� � �� <br /> Connection By �; � / � <br /> Signed � � <br /> Address �Customer I <br /> / � <br /> Phone ' � <br /> Sewer District �I , <br /> DESCR P ION: p/ <br /> Lot � ' Block d �T� Monthly Sewer Service I <br /> � <br /> Plat ' - 4✓ <br /> Unpla ted Description �Monthly Sewer Constr. <br /> Trunk j <br /> Type P rmit: Lateral I <br /> ,� L <br /> Hamarks: Abutting Lot Line ft. <br /> N, 5, E, �N <br /> � . r� <br /> u <br /> � � „� �. ��.���— <br /> G Approved BY pity E ginecr � <br /> , Issued By � , J � ���" <br /> Inspection By�— <br /> Datelnspected <br /> rvo. 23848 <br /> SEE SKETCH ATTACHED <br /> INSPECTION <br />