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evereft CHART NO. �� Z��9�� <br /> e ,�d s � �-,� <br /> /v _ g _ ? � <br /> Ciry of Everett � ��� � � � <br /> Engineering & Commur,ity Services ✓ �� �� �. � � <br /> Sewer A�plicati�n and Permit /�o• 2� � g 3 <br /> NO. �� � l� � DATE �3/ // / <br /> Service Address � � Utility Account No. <br /> � Bil!,ng Address — <br /> Permit Fee <br /> City, State, Zip Connection Charge�s�_ <br /> Owner (Mortgagor) Total Fee � <br /> Billing Name <br /> Connection By <br /> Address � <br /> Signed_ � � j <br /> l..- � <br /> Phane �OSO1� <br /> DESCRIPTION: <br /> Lot � - � SeWe� District <br /> Block : r / <br /> Plat�� '� � � Monthly Sewer Service <br /> Unplatted Description <br /> -----_Monthly Sewer Constr. <br /> Type Permit: �(/L-,�J �— Trunk <br /> -- —•--_ <br /> Remarks: � �� �Gc — <br /> Lateral <br /> `3 � Abuttin Lot Line <br /> ���-L�—� � � i� N, S, E, W <br /> --__ ----�ft. <br /> APProved By • / . <br /> ' Cny Enginear <br /> Issued By r' �/ <br /> Inspection By r, ;� <br /> o — --- Date Inspected � � ��� <br /> SEE SKETCH ATTACHED , <br /> � ���� �� <br />