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_:_- - -� ._... <br /> CHART N0. <br /> fi,' /i�� .�_';; � �. � <br /> evereri <br /> .� �— _ <br /> � i�)`� /E 4� � <br /> e ,�-�6 � � �' �� <br /> City of Everett �j <br /> i <br /> Engineering & Community Services , <br /> Sewec Application and Permit { <br /> , <br /> NO. : a DATE � i' � I <br /> � <br /> . I <br /> Service Address _.— <br /> � � Utility Acr.ount No._ i <br /> ��J'� � �� <br /> BillingAddress�- — '� � �� Permit Fee_'_�_ <br /> City, State, Zip �� �%�* �' � '� Connection Chargels) <br /> �✓ <br /> ' � Total Fee `�� <br /> Owner (Mortgagor) �' <br /> Billing Name --� <br /> Connection By — /JJ < ' ' ' <br /> Signrd ,/( /,�''4'� /!Ci•.e..�t,t.t-af' _ + <br /> AddfB55 � Cmromnr <br /> ; /� ; _ �%� Cl <br /> Phone <br /> DESCRIPTION: Sewer District_ — <br /> Lot Block Monthly Sewer Service_ <br /> Plat I <br /> Unplatted Description � �� �� ' � �'f Monthly Sewer Constr. I <br /> � ' �,, !/ '" "' Trunk � <br /> Type Permit: �j/ � ' .l .� f` _ < .✓ <br /> — Lateral <br /> '� Remarks: Abutting Lot Line <br /> N g E yy _ it. <br /> ' <br /> . 1 <br /> _ — i <br /> _ — — Approved By �� i <br /> Cny E�g�nner , <br /> __ ' , /r.. �. <br /> i <br /> — Issued By � — '" / <br /> __ ^ � i <br /> Inspection �/J —�1� <br /> __— � <br /> --- ---- --+ <br /> _ _ __ Date lnspected .t— ' — <br /> � -- . . . . . _ _ . .. � i <br /> SEE SKETCH ATTACHED N0. <br /> �".,'�.+1�A� 9 . � ':; ,. »�`::.>ka .� .�. � ' r5� .:.-.a:_ <br /> � � <br /> , �.k:k: . �.J iSCu.. li.:'-` -. ..'�.,.,. �� N!... <br /> .� <br />