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�' � <br />� <br /> I <br /> I li <br /> il Gr 1 <br /> i everett CHART NO.�'G-�'�J i � <br /> I � � <br /> � <br /> �j i �os�cs' � 1 �� <br />, , <br />� 7 - 7 g 1 <br />� City of Everett /Z �. <br /> Engineering & Community Servicas <br /> Sewer Applicotion end Permi# ��` �' <br /> , a <br /> NO. �� '�' / � � DATE ' � �/� <br /> Service Address ' �_ -� % � ��- � Utility Account No. � I <br /> Billing Address _ Permit Fee_ � <br /> City, State, Zip Connectirn Charge�s) "^— � <br /> Owner �Mortgagor) Total Fee % <br /> Billing Name <br /> , ' � . <br /> Connectiun By _ : / <br /> � ' � <br /> Address— Signed_�-'' , � <br /> Phone a„�o�. <br /> a <br /> DESCRIPTION: Sewer District <br /> Lot _ Block <br /> Plat _ Monthly Sewer Service <br /> Unplatted Description Monthly Sewer Constr. <br /> Type Permit: ;, , v — Trunk r <br /> Laterel i <br /> Remarks: <br /> � .. Abut[ing Lot Line <br /> , �_ r.� •� , .J. ' N, 5, E, W <br /> ..t..- � � rL , � ��`� � / n // , f'� _..c "L/�� ft. <br /> APPruved$y_� - %i� <br /> Cay Enpineer /- —'— <br /> . ' � <br /> Issued Oy <br /> �- _.-- —_____—__ InspectionBy r"t�i����itf.�a,��— I <br /> o-- -- — — — Date Inspected_�_� • �� <br /> SEESKETCH ATTACHED N0. <br /> ����� <br /> I <br /> I <br />