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. '---� <br /> I <br /> i CHART NO...�'-- ''== <br /> , . . -.- <br /> , everetl � , „ � . <br /> e - ^ . .�. � . _ � <br /> ! City of Everett <br /> ' Engineering & Community Services I <br /> Sewer Application and Permit <br /> N0. ; _I l [� �� DATE <br /> Service Address 1' � J � �����S �` J i Utility Account No. _ <br /> �� <br /> Billing Address L <br /> S�.jnl�� Permit Fee n' J ���'s — <br /> �.• � ,j� y s� � Connection Chargelsl <br /> City,State, Zip��i � ' 7-�--- <br /> � � <br /> Owner (Mortgagorl M M M � Al �LL Total Fee h�� r,�� . <br /> Billing Name s l� A)� <br /> Connection By � � T �� V� F-�'�•�� <br /> Address Signed c��s�o�� i <br /> Phone <br /> DESCRIPTION: ..- Sewer District <br /> Lot Z � � 2' � Block ���'� Monthly Sewer Service <br /> Plat�� J� nn n/r".�S � /'� <br /> Unplatted Description l�' _Monthly Sewer Constr. <br /> -- Trunk — <br /> Type Permit: _ <br /> Lateral <br /> 5 t y,� : c'PA � +� _ - , <br /> Remarks: - Abu[ting Lot l ine <br /> i.-aa9Qf,tiC'o�- .o+�+Ja�' Lp-,��v.�iXi-a-,•�.O N, S, E, W— ft. <br /> -� P' .s�' d.�. r" <br /> ���,..-L — .La�',.C- i) . <br /> ��,..�o-e,.� o-.� r'�.-.�.- ,��•-� ` � /, <br /> ApprovedBy -t� /"�-r")T�Nt�f.} <br /> Ciry Enpinee,J� � <br /> . • I y7 / <br /> alu'r. `v+' <br /> / �'T'"~ Issued By - r <br /> .� � /t> h�• a,.,- �.3 � <br /> � ,�r <br /> �^- � ' - . <br /> y ) <br /> Inspection By �- •,•' '�'�A '� +-� _ <br /> � <br /> __ Date Inspected�'��/ - �7 <br /> 0 <br /> � SEE SKETCH ATTACHED N0. � <br /> ! ifd51'f C,I IUi•I <br /> V <br />