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K <br /> 1 <br /> CHART N0.—, � �`� ' �� �^ � <br /> � everett � <br /> t���7�� ' <br /> c� e ,o,�� � �� . <br /> ��� City ot Everett i � <br /> H � <br /> 'yy ' Sewer Application and Permit <br /> M �3 � i <br /> H H i <br /> � �'� I N0. Z-T.TS�J DATE .f ' / � - Ci n - <br /> � NH Iz � g Utility Account No. <br /> ,�d I Service Address� <br /> � t~i�y � �NQ � 3 I� �rt-�Son/�.-- Permit Fee <br /> F+ t+a O Billing Addr <br /> ��y � � 1 <br /> M Connection Chargels) ' <br /> � y Ciry,State, 2ip <br /> i <br /> Total Fee <br /> C t~ii H Owner (Mortgagor) � <br /> n Cy i <br /> � ��� � Billing Name <br /> '� I Connection By � f �� '' � 1- �"°vf�' — <br /> N <br /> I Signed cw�o�,�e� ' <br /> Address <br /> � Phone <br /> $ewer District <br /> DESCRIPTION: <br /> � �at Block Monthly Sewer Service <br /> �1� � ; <br /> � Plat Monthly Sewer Constr. <br /> I Unplatted Description <br /> , �� -� I, Trunk <br /> IType Permit: Lateral � <br /> '� � <br /> � � <br /> � '� � I / • / < r� <br /> I Remerks: � Abutting Lot Line <br /> n1 t/ S� / � /� � ...� )�l7 /�d,� . <br /> N S E W_ tt. I <br /> !'! I nn% " __ i L'✓G� �� <br /> i ' <br /> � <br /> � �^. <br /> � � Approved By cuv e�o��..r <br /> �3 /7 /l�r,e��, �� g5 ' � <br /> il a j�8 GL` �" /�n d IMPO�TANTI r� n n . � IC � — <br /> 1� Issued BY�+-� <br /> �� I CALL 1A00-0Y4•665648-HOURS <br /> � PRIOR TO DIGGINa <br /> � � � <br /> CALL 269�BB�f FON INSPECTION <br /> i Inspection BY <br /> � -------- /,� 1( �r'J <br /> � Date Inspected <br /> ISEE SKETCH ATTACHED N0. Z7.TSrJ I <br /> � UTILITY IlILLING ' <br />