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�,.��J <br /> 1 <br /> CHART NO. � �� �� '� <br /> everett <br /> e <br /> City of Everett � <br /> 3-25� <br /> Sewer Application and Permit <br /> No. 23900 DATE Ii : I ' � <br /> Service Adoress ' - ' � Utility Account No. <br /> � , . (_, <br /> 8illing Address � - - �� � � Permit Fee l ' - <br /> City,State, Zip % �-- � - �'�" ' Connection Charge(s) <br /> �_ �_, <br /> Owner (Mortgagor)�' � % - �- � Total Fee �'-� ' <br /> , , . C , . <br /> Billing Name �: � � • � ` % - -r <br /> , . ,. , i� <br /> Connection By � — � �r. . -,. <br /> . � <br /> ( <br /> Address-�` � � ' ' ��� t- - Signed� <br /> _ - � .- . _. . , . ,' C �1 � Customer <br /> Phone -- •=t '�J'% � <br /> DESCRIPTION: Sewer District ; <br /> Lot � � Block �- `� ` <br /> Plat� � �- < < - �- ;" Monthly Sewer Service <br /> Unplatted Description Monthly Sewer Constr. <br /> Type Permit: Trunk <br /> Lateral <br /> Remarks: <br /> —� Abutting Lot Line I <br /> n � N, S, E, W ft. I <br /> � �� <br /> Approved6yJ �` !;C �i � ,,. ' I <br /> Ciry Engineer � <br /> -- Issued By l � , � , i <br /> i <br /> _---, -- '�� i <br /> Inspection By � , l�"""'-'� � <br /> Date Inspected .��� 3 �i� <br /> SEE SKETCH ATTACHED N0. Z39O�S� I <br /> I <br /> INSPECTIOtJ � <br /> I <br /> - • �'. <br />