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everetl CHART NO. � �- 1 �" <br /> � a . , . .' ,_ <br /> � , <br /> / '_� `� <br /> r� , �v � <br /> City oi Everett � <br /> �� /l% , , <br /> Enryineering & Community Services �!�� �__- < <br /> � <br /> Sewer Application and Permit � - — <br /> , <br /> N0. ���I G � DATE .�'• .� .- ,✓ <br /> Service Address_i'-� ? ; t i � . <br /> Utility Acco��nt No._ �_ <br /> Billing Address � `� �" >�> � �""^� <br /> --.--�_ Permit Fee � <br /> City, State, Zip Connection Charqc(s) � <br /> Owner (Mortgagor) . :' �. _ ,' � . /� �` <br /> " Total Fee <br /> Bi;ling Name i <br /> -+�-- <br /> Connection By; :� % , "% - -✓-� %/ . <br /> Address �.��� �1 � - / ,;�� <br /> Signed -1� �� �: ;r�al'{J <br /> PhOnB_1L i - c)}%O ` � ' �i'� �� Cu:tomer <br /> DESCRIPTION: <br /> Sewer District <br /> Lot Block <br /> Plat Monthly Sewer Service_ <br /> Unplatted Description Monthly Sewer Constr. <br /> Type Permit .�.'�.: r �, Trunk <br /> Lateral <br /> Remarks: <br /> Abutting Lot Lina <br /> � <br /> N, S, E, W— ft. <br /> APProved Ey- . <br /> City Enpineer <br /> i� <br /> Issued By i- • � - � � <br /> � <br /> � <br /> / � <br /> I <br /> --_ Inspection By fiz�— ' <br /> �'✓�) — � <br /> p --- - Date Inspected_ .'S - 7 "- i� <br /> SEE SKETCH ATTACHED Np i <br /> iri <br />