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1 <br /> � <br /> � <br /> I <br /> i <br /> � '� �..� / . . . '� �� <br /> I <br /> 1 <br /> everett C; ! 'j I� CHART No. II <br /> � jt' , .,, <br /> ��r.�,�4.�{ <br /> � e . , �,� ,T�. . <br /> , _ ��.� . <br /> f City of Everett Clf�Y 0� ;:l';_:.� �T <br /> � Engineering & Community Services E��'����`�"�`'' �`��'f� <br /> Sewer Application and Permit <br /> NO. � ' DATE � ��� � <br /> I �, _ <br /> Service Address - � . O � ! . � Utility Account No. <br /> I Billing Address � �:��` � - �:• % :� � �G- Permit Fee .JJ ` � <br /> i <br /> Cit State, Zi � � % �l� Connection Chargels) �-- <br /> v, a� � -;. X -:'U <br /> --- � . � <br /> Owner (Mortyagor��' '� - • ' � Total Fee �J�� � <br /> Billing Name . �_� <br /> Connection By ..� _ �+ <br /> Address Signed_ � , r ; � :•. L,��-- r <br /> Phonel��- %'� % y - c��,��„��,� <br /> , -,r � � <br /> -�`�✓_1//,. <br /> DESCRIPTION: Sewer District <br /> Lot -.-•' <w - • �s Block � ---__ _ - ------ <br /> " ' � ' ' MonthlySewerService__�__�_=v <br /> Plat_ _�'��', ; /," '(r, - <br /> Unplatted Description ' __ Monthly Sewer Constr. <br /> Type Permit: ' �'- , lrunk <br /> % .. i . <br /> � Lateral <br /> � <br /> ' Remarks: <br /> ( Abutiing Lot Line y - <br /> N, S, E, W _it. <br /> i <br /> � <br /> Approved 8y � <br /> — ' cnv enginec, - <br /> i <br /> f �ssued By!' - . � __�___ <br /> I <br /> Inspection By _ - _ <br /> ( -- __ Date Inspectedl �� � i,� - <br /> � e �����----- <br /> i SEE SKETCH ATTACHED N0. <br /> � � � r � i,�, <br /> i ,�, ,§ <br /> . . . .. . .. . il ' ... . . . . .. �.':s:p n. .. <br />