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i <br /> CHART NC. I <br /> everetl <br />, e �;�` <br /> � � _ , -, - � � I <br /> City of Everett ��/�- <br /> Sewer Application cnd Permit <br /> A i�iioie� � <br /> N0. 24113 ��'.% DATE <br /> �' � t?/ � I <br /> Service Address � Utility Account No. i <br />( Billing Address Permit Fee ao�• <br /> City,State, Zip Connection Charge�s) <br /> Total Feee poe• ' <br /> Owner (Mortgagor) f <br />� Billing Name � <br /> Connectian By Citr oi t��r�lt / <br /> ' ned eill ttath�ray <br />� Add�255 � Customer <br /> �1 � <br /> Phone � <br /> DESCRIPTION: Sewer District <br /> Lot Block� Monthly Sewer Service <br /> Plat 1 <br /> Unplatted Description } Monthly Sewer Constc <br /> 11 Trunk <br /> Typc Permit: r�p�ir <br /> Lateral <br /> , �� . <br /> Remarks: ,}; ,,/.�,,r.- � . �. �w, ,,, .i�.,�( <br /> _��_� Abutting Lot Line <br /> � '' ', � N, S, E. W ft. <br /> a f - � <br /> c�i ., ,._ .. :. �i� . .� y � s ,�- <br /> �r�, r/ . � � i�'�� �1`• � <br /> r. R. Th�al <br /> Approved By -- <br /> Ciry Engincer <br /> &. Dond <br /> Issued By — <br /> ^ <br /> Inspection By � ' �/ }�Jd � rt— <br /> Date I nspected �� ��� - { � <br /> •^9- <br /> SEE SKETCH ATTACHED N�• 24113 <br /> INSP[CTION <br /> _ - � <br />