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r <br /> r <br /> � CHART NO. <br /> Ievereti <br /> e � <br /> � <br /> � <br /> � <br /> City of Everett � <br /> Sewer Application and Permit ' <br /> ,�: . . <- :. <br /> NO. 24434 DATE -�7L�!_r'-� . B za_ za- �- . � , <br /> I <br /> Snrvice Address �'- � <br /> _ Utility Account No. I <br /> n'"�J�- <br /> BillingAddress �` Permit Fee ./GZ�= <br /> -� <br /> City, State, 7_ip �/ Connection Charge�s) I <br /> Owner (Mortgagor) _- -'- � Total Fee �� �' � <br /> - I <br /> Billing Name i <br /> Connection By � � � �j.� I <br /> Address Signed���i;� �� .-�:�__ � <br /> / c��,�o�,,,., � <br /> Phone- � ti � � ����/ _ i <br /> DES�C���PTIOyN:, � / Sewer District _ ; <br /> Loy�--'«s"1 Block � � <br /> Plat ��n-�--'+'�� Monthly Sewer Service <br /> e <br /> Unplatted Description plonthly Sewer Constr. , <br /> Type Permit: .��, -- Trunk <br /> Lateral <br /> - i <br /> Remarks: <br /> Abutting Lot Line � <br /> N. S, E, W ft. � <br /> I <br /> I _ <br /> Approved By � � <br /> City EnB�neer , <br /> I <br /> Issued By � j , <br /> � '� • i <br /> Inspection By � '�� ' <br /> — I <br /> :� I <br /> -- ----.--------- Date Inspected� I `� I�. � I <br /> SEE SKETCH ATTACHED No. 24434 I <br /> , INSPI:CTION <br /> L � <br /> I <br />� <br />. <br />