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� n:.r..,, �1n rcT '-• �_�.{ `.+ <br /> CHART � <br /> PV 11 ;I <br /> � , <br /> � • • / � _I � . <br /> � -.-- .�1`. <br /> 1 �' J �� �f.J <br /> � � 1 L � ,+— � <br /> � \ _ <br /> i ;<} I � � ,��/3��7� , , <br /> City of Everett � . .. <br /> Engineering & Community Services �i' .l ...., <br /> Sewer Application and Permit � <br /> _ -� <br /> N0. �� ;� .; ,) l; DATE � _ <br /> Service Address ' ' � " ' +'= Utility Account No.__ <br /> Billing Address � % ' Permit Fee � _ ? <br /> City, State, Zip � Connection Chargels) 1 <br /> Owner (Mortgagor), Total Fee_ <br /> Billing Name <br /> Connection By '''^' ,.�+ I <br /> y �/ i <br /> : . . �I.—''...` .. <br /> Address . �' t i� / ' . Signe��_��•�.-/! �.� �'..__ e.... �, <br /> r� Cui�omer <br /> Phone-- i J � � — — � <br /> i <br /> DESCRIPTION: SeH•ar District " i <br /> Lot Block - ` ' � <br /> Plat ' ' r`` ✓ Mon;hly Sewer Service_ __— , <br /> Unplatted Description _Monthly Sewer Constr. <br /> Type Permit: — Trunk <br /> � . �._/ Lateral <br /> Remarks: - �' ' <br /> Abutting Lo[ Line <br /> N, S, E, W _ft. <br /> Approved [y • <br /> GIY Enginrer �-- <br /> �SSLICd �Y�—_�__" "'_ —_—_'_. <br /> Inspection E3Y—=2—��------------ <br /> — / <br /> �� <br /> Date Inspected `' �',� §� <br /> p ' -- <br /> SEE SKETCH ATTACHED rd(� <br /> I�J'.ef�i ��. 11. � . .. -. <br /> � t'" ti � �,.` <br /> �kl • '��br R� �{!'n;,'� isw A j. �'tl.�r'` <br />