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� <br /> r --�^ CHART NO. <br /> everett I <br />� e ; <br /> r rt <br /> City of Everett : <br />�� <br /> Sewer Application und Permit <br />; rvo. 24990 �AT� /� � �-- i <br /> i <br /> Service Address y �a Utility Account No. <br /> - -- � <br /> Billing Address�✓'—r0 Permit Fee �n <br /> City, State, Zip�-�..�.�,� '�/a� . ��,�0=-:t— Connection Chargels) _ <br /> ��-��_ i�._ <br /> Owner (Nortgagor��.r,�$-tz�' �y�������.aial Fee �6 i <br /> Billing Name _ <br /> Connection 8y — � <br /> � . I <br /> Address Signed ___ � <br /> Customer <br /> Phor.e�'��- ���� I <br /> DESCRIPTION: Sewer District I <br /> Lot Block � <br /> Monthly Sewer Service � <br /> Plat � <br /> Unpiatted Description Monthly Sewer Constr. <br /> - Trunk <br /> Type Permit: � C�„(� , <br /> Lateral ; <br /> Remarks: � � <br /> Abutting Lot Line <br /> N� S� E, y�l ft. j <br /> I <br /> /' /� 1 � <br /> Approved By�//�•✓t " ��� <br /> City Engineer <br /> a /��Issued By � C - <br /> Inspection�� /�� ` � / <br /> « <br /> ' _ Date Inspected %�- z� NY — <br /> SEE SKETCH ATTACHED NO. Z4J7ti I <br /> I <br /> INSFECTION I <br /> � � <br />