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—r . <br /> � � <br /> � _ . CHART NO.Z I8-?�i -5 <br /> everett r i , <br /> `� Jc{ ' <br /> i �j `.... �'•, . . . . <br /> � �: R <br /> City of Ererett I � Z � �g � <br /> ,.�� i <br /> Sewer Application and Permit r��'� = ' <br /> N0. 2361V OtlTq 6/3/i0 <br /> DATE <br /> Service Address 1�1 �� ��°� �Jtility Account No. <br /> Billing Address s~ ' Permit Fee 10.00 <br /> i�tt. Ita. 4i201 <br /> City,State, Zip Connection Chargels) <br /> ( 9a9 ��� J' �� 30.00 <br /> Owner Mort or) Total Fee <br /> Billing Name $� <br /> Connection By �'1' <br /> i—- . <br /> � � / _L� . <br /> Address Signed'•. ' • . -. "1`' r .<i s .i / ��.-.� <br /> � � ` �Cusromer <br /> Phone �� � <br /> DESCRIPTION: Sewer District <br /> Lot 1� = Block 3�� <br /> Plat ��L Di�. L Manthly Sewer Service <br /> Unplaited Description Monthly Sewer Constr. <br /> Type Permit: AlEssatlon Trunk <br /> Lateral <br /> Remarks: <br /> Abutting Lot Line <br /> N, S, E, W_ it. <br /> g. Itazr�a <br /> Approved By <br /> citr Enginee. <br /> E. HOAd <br /> — Issued By <br /> � . ^~ inspection By �-�� � F'�n ---- <br /> --- � <br /> _ �' Date I nspected � �V N E g Q <br /> SEE SKETCH AT7ACHED NO. Z3616 <br /> INSPECTION <br />` - — - c- - - — <br />