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evereit I CHART N0. f� �____�' __i_ <br /> e � - , � ___ <br /> , i ��;_, ,'=� -�� <br /> City of Everett � �/� � �` <br /> i <br /> Engineering & Community Servir.es � <br /> Sewer Application and Permit � <br /> N0. UATE � • ! 1 II <br /> --��--— L - <br /> __ _ <br /> i Service Address��1 C E` ��� ���. � �: <br /> Utility Account No. �` � � '- �. � <br /> Billing qddress � � Q �L (� � � - <br /> -'��-�� fPermi[ Fee �v O u <br /> C�ry, State, 2ip �- . �4. v t�r � l�i) � • - <br /> -'� � Connection Chargels) � ��"ri,�a�� <br /> OwnerT---- -- <br /> (Mortgagor�TE�L�p, • ( <br /> �'�1-_u � �__ Total Fei� � <br /> � <br /> � OillingName_ri �t � � r -- <br /> �. � <br /> i - - <br /> Connection By �`��� .�% C ( � <br /> Address�- CL`Z� ���T� J l l.1 <br /> � _ _ Siynerl_. <br /> ..� . . .. �.�„n;�,��,� - -- - <br /> Phone_ -�e°"— ��_�—�'��`] --- <br /> ' DESCRIPTION: <br /> i ' LOt �� _ '�eWer Ihtilnci— __� <br /> _ Block___ <br /> Plat ( ... t_ ��.y , , Monthly Sewer Service._ �- � � . <br />� j __.__�a��_—�_.� 1" Y � �, _ <br /> Unplatted Description <br />� j Monthly Sewer Constr. <br /> i I <br /> i TYpe Permit: _^_���,� �N��, 1 C Trunk <br /> � Remarks: Lateral <br /> y� � �-- Abutting Lot Line <br />, I _y �a N' S' E• W._ (t. <br /> ; ---[i��L�L1i� �./ —� ✓� —�I � ----- <br /> i <br /> . ---------___._—__.--_ <br /> i <br /> � '�__l'� - --- <br /> ----� ,i¢� ApPruvrd I�v-- -------- <br /> �.1�Y EII�iIIYYI �{ � <br /> _ ---- — -- ---- Issued By�_ <br /> -- ' <br /> -------- � <br /> � ---- .. . Inspeclion � ,r-�.� <br /> _--- <br /> _ __ _ — <br /> p.._---------- � ._ - ---���—_—__' <br /> Datelnspected__/ <br /> SEE SKETCH ATTACHED <br /> ���� �� I���� <br />