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, <br /> CHART N0.=� �g���—s <br /> ever <br /> ,� ,--, , <br /> V���l�l' � _' � I — �_, �. <br /> City of Everett <br /> -��, <br /> f <br /> Sewer Application and Permit <br /> NO. 23793 DATE �U"� �- pd <br /> Service Address � Utility Account No. � <br /> Billing Address Permit Fee�_ <br /> City,State, Zip Connection Charge(s) <br /> O <br /> Owner (Mor4gu�or) Total Fee i� �� <br /> Billing Name -- <br /> Connection By��-"='""' ( �"�/ " <br /> /, ; <br /> ��n. 7 /� �., Signed � ' <br /> Addf¢55�, Gntomer <br /> Phone..s��R �'p � <br /> DESCRIPT_ _ ION; Sewer District <br /> Lot �.�-/Y - B�ock..,a���' Monthly Sewer Service <br /> Plat <br /> Unplatted De ription Monthly Sewer Constr. <br /> Trunk <br /> Type Permit: <br /> Lateral <br /> Remarks: Abutting Lot Line <br /> N, S, E, W ft. <br /> �l <br /> Approved By " � <br /> Ciry Engineer <br /> ISSU2d By �--- <br /> — I nspection By� ' <br /> �6 <br /> Date Inspected � 0 2 '� <br /> SEE SKETCH ATTACHED N0. 23T93 <br /> INSP[CTION <br />