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I <br /> i <br /> CHART NO.— ' <br /> everef! <br /> e � <br /> City of Everett <br /> Sewer Application cnd Permit <br /> N0. ZSZ6S DATE ��Il �'s� _ <br /> a ��-- � <br /> (J Utility Account No. � <br /> Service Address y� � <br /> /o m <br /> BillingAddress� 2o PermitFee I <br /> n i 1� <br /> City,State, Zip Q o?�� ConnectionChargels) � I <br /> �� {L� N= <br /> Owner (Mortgago �'n _t�-=�"�r�-=�--�"�� Total Fee �� c o <br /> m� <br /> Billing Name �T� <br /> s-=i <br /> Connectian BY ^' <br /> ... <br /> Signed Q Z <br /> Address — c <br /> cu:�ortk� �_ <br /> e.�rr <br /> Pno�e <br /> AS - .s573 � � <br /> � <br /> DESCRIPTION: <br /> Sewer District �i� <br /> Lot Block Monthly Sewer Service I �., <br /> Plat N <br /> Unpletted Description Monthly Sewer Constr. I <br /> C N <br /> N <br /> � Trunk z c� <br /> �r <br /> Type Permit: ' ^' <br /> Lateral �o <br /> -i <br /> x <br /> Re+narks: Abutting Lot Line > <br /> --�-- fL = <br /> �[Le �S/ Go .+c— w �V N, S, E, W � <br /> x <br /> I N <br /> �� I Z <br /> I 0 <br /> 1 <br /> H <br /> f') <br /> Approved By ' �^ <br /> c;rv e�q�oem <br /> Issued By_1Z=-s�Y-� <br /> _ 1 <br /> Inspection By � "'a�e��~� I <br /> Date I nspected `�'�� 's r <br /> SEE SKETCH ATTACHED No. 25268 <br /> i <br /> INSP[CTION I <br /> J <br />