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CHART N0. I <br /> everett i <br /> e � <br /> City of Everett ��T�D I i <br /> � <br /> �-as- 8a '� <br /> � <br /> Sewef Application and Permit � j <br /> No. 23849 <br /> DATE ��� ���`� �'� <br /> Service Address �'�"�- �� ' 's- ��'� Utility Account No. � <br /> � � �.!" Permit Fee � � � <br /> Billing Address�' >/>' ' *-' "Q "`'�'`�' � <br /> City, State, 2iq�t�,lt,_/�'� �^- � �yv Connection Chargels) ' <br /> � S'� <br /> Owner (Mortgagor) ����a��ur Total Fee ''� <br /> 0 <br /> Billing Name / ����"��`'4"� <br /> . <br /> Cunnection By � <br /> �,ddress Signed c�s�omer <br /> Phone <br /> DESCRI�TION: � Sewer District <br /> Lot """�" Block___gl_�— Monthly Sewer Service_ <br /> Plat�_�1"G+'!� �,u�' C <br /> Unpla ted Description _Monthly Sewer Constr. <br />� Trunk i <br /> Type Pennit: I <br /> � Lateral <br />� � � �,z — <br /> , ,-u-�-� �T <br /> � Remarks <br /> i Abutting Lat Line <br /> N, S, E, W ft. <br /> I <br /> /` .� <br /> I Approved By �/�"" ��'��J� — I <br /> Ci�V Engmcer �� ��. <br /> , i Issued 8Y ' /. �` ��"'"'� --- <br /> � � <br /> � <br /> I — InspectionB �� )^� 41r=�~ I <br /> 1 y� <br /> � -_, �� ��� _ == <br /> Date I nspected <br /> SEE SKETCH ATTACI�ED No� �3849 <br /> _� � � . � �� , <br /> -- — _ —' ._ _ . <br />