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r--_ <br />� <br />� <br />� <br />� <br />�, � • � CHART NO.� ��! -i''• - :i # <br /> everett <br />�, t j�, . <br /> I � . "� � <br /> I J'o j ____` - � <br />; City ot Everett ��// 6 "7 � ' <br /> � � <br /> Engineering & Community Services , <br /> r��,- _ <br /> Sewer Application and Permit - i <br /> � <br /> NO. � % ::; �J �! DATE ���/� � <br /> ; , <br /> Service Address_��1 U� i Utility Account No. j <br /> . ., . . <br /> 6illing Address � 1(OA 'i�/-.-..T �.< ./ Permit Fee �/lJ' '''� I <br /> City, State, Zip " � :'✓:P. . �� Connection Chargels) � <br /> . <br /> j � �`� 1 <br /> Owner (Mortyagor) . ' - r .• �, - � Total Fee . �1 j <br /> , — J <br /> Billing Name --�".:-r "_ �_�- 1 <br /> :1 �- j <br /> Connection By ! �'i�-.�.-c�� _,f - <br /> � <br /> Address _ Signed ��t i_L, . :,iJ"�'- - • _.. <br /> ` Cucromcr <br /> Phone JJ �/ " �O/� <br /> 1 <br /> DESCRIPTION: Sewer District � <br /> Lot � - � Block � � � 1 <br /> Plat_ . ,'`f f.' : � —. � Monthly Sewer Service _ ' <br /> Unplatted Description Monthly Sewer Constr. <br /> TY"r� Permir. ;_..-.' i- _' . Trunk-- <br /> �� Lateral , <br /> Femarks: � <br /> Abutting Lot Line <br /> _ N, S, E, W _ ft. <br /> _ '��%/ • <br /> Approved Ciy _ t:f. _ � <br /> ' City Engineer + <br /> �' ` i~ �..� /:�' 1 <br /> Issued By �^ - '=�=" - � <br /> _ i <br /> � <br /> Inspection By ���-�?��-- � <br /> Q _._ Date I nspected � � " � 7 — 7 �'� _ <br /> SEE SKETCH ATTACHED N0. � <br /> ,� . . � i;lli.)I . . <br /> r � <br />