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�- e -� <br /> � ���r �,• Ol N[T ,,•_ Z -� � . _ _- <br /> . ;: <br /> 4 CHART NO. � � z ` � _ <br /> everett �� � <br /> I �" '' / <br /> ; e ��L , <br /> : . <br /> City of Everett *- <br /> Engineering & Community Services '� <br /> Sewer Application and Permit <br /> N0. � � �; ;J G DATE ��� � � � <br /> Service Address ��� � �I �-� lL'�� r--li i"i` •=T' Utility Account No._. <br /> � Billing Address 1-:,'.� t . �r.s t.�L Permit Fee (-'� �' _ <br /> � <br /> City, State, Zip�-.- ���k��- �r � ��� �� Z'�' � Connection Chargel:!_ �-- <br /> Owner (Mortgagorl�-'c'�-''-�4� �--�-`�� �- ; Total Fee _ (:� ' c: <br /> <... <br /> 9illingName -->���' :r- <br /> i'onnection By •��- 1 �"� ��t'�'�-N�--7Z <br /> � � i _..-�- <br /> ; Address�"--�� `�,�'4�� �� �.-�47"a�v Signed�� � /� L <• , �'J: / / <br /> CVS�O(118I ��, <br /> Phone �r.����1 - j��-7C' Q <br /> � DESCRIPTION: SewerDistrict � "�� � �1`t-"'"� � .� <br /> Lot Block � <br /> Plat Monthly Sewer Service���'?l-,' � � <br /> Unplatted Description �'�>i[-: . �� 4'_ ���A. Monthly Sewer Constr. <br /> '� — ��l- '� <br /> Type Permit: ��v� Trunk <br /> Lateral <br /> Remarks: <br /> Abutting Lot Line <br /> N, S, E, W ft. <br /> Approved By L.. � �(_ ,�J.`-/i ,� ; � <br /> City Enpineer <br /> l <.. .� �� C. /) / �.1�(. <br /> Issued By _ <br /> I , Insoection By��(f'�-� -e-�' ?2��-..1 <br /> i � <br /> IDate Inspected_�lJ 7 <br /> Y \ <br /> ! SEE SKETCH ATTACHED ) N0. <br /> � � ;- � � i��� , <br /> � <br />