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CHART N0. <br /> everett <br /> e �� �� � - <br /> , <br /> , <br /> . � � <br /> c�iy o, everecc (, <br /> .. a <br /> Sewer Application and Permit <br /> N0. 241i8 DATE '--- <br /> Service Address ���a ������0 Utility Accaunt No. <br /> Billing Address <br /> Permit Fee -- <br /> City,State, Zip <br /> Connection Chargels) <br /> Owner (Mortgagor) Total Fee Ike! — <br /> Billing Name <br /> Connection By�!—C�NJtt-- <br /> Address __ Signed o <br /> Phone_ <br /> DESCRIPTION: Sewer District <br /> �ot Block Monthly Sewer Service <br /> Plet <br /> Unplatted Descriptfon Monthly Sewer Constr. <br /> Trunk <br /> Type Permit: <br /> Lateral <br /> Remarks: Abutting Lot Line <br /> ii, �• i.� ,� — �a. 's ,, . �' • <br /> N, S, E, W ft. <br /> �.�. 1 3 I�i�i�ti. !� 7 %��. �� i�/, /�. —'- <br /> � r/, �. � � �> _„ � ;/�� . I ' '. . A'. <br /> Approved By <br /> ci i eer <br /> Issued By <br /> — Inspection ey .7i I� �/, ,r � <br /> Datelnspected ' '` � �-- <br /> SEE SKETCH ATTACHED N0. Z4118 <br /> ' I INSPECTION _ � <br />