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_ �._ _ _ � _ <br /> T <br /> ! <br /> � CHNRT N0�-� =%"� ^� � `� <br /> �everett • ;;i <br /> � � : . <br /> f.'7 - � <br /> C": <br /> � � <br /> City of Everett c.> <br /> Engineering & Community 5ervices <br /> Sev�r�r Application and Permit � <br /> rvo. 22465 DATE ��i�Il' <br /> Service Address � ��-3 -.�/`-� -l�-y N- Utility Account No. <br /> Lr%"' <br /> Billing Address���"� ��'� �� Permit Fee ;�'d <br /> / / '/ � ,. ._---�"''� <br /> City,State, Zip /��• -��-�-�� �✓ � '� • ��"Z�� �nnection Chargets) <br /> i" <br /> Owner (Mortgagor) �`• ���� ' � �� Total Fee JD <br /> ' r/ � <br /> Billing Name �r �![� • r,��, ^' ��=_„".�. <br /> is; <br /> Connection By l�^-- = • =/ l-✓' ��--"� �% -� <br /> Address ���0 � �''�fT+� �' %' '- Signed `�-� . <br /> � � r, . �;r customer <br /> Phone �i�- y���� <br /> DESCR�PTIO� � Sewer District I <br /> Lot�o -� Block � '�� / <br /> Plat—�;: � / %`- .� C'a . �� . <br /> Nlonthly Sewer Service �y���--"' ��" <br /> Unplatted Description Monthly Sewer Consir. <br /> .r Trunk <br /> Type Permit: �,,,,.,;• A,.. ,, , ( '- <br /> r� _ �_,.�'- � ' � Lateral <br /> Remarks: <br /> Abutting Lot Line <br /> N, S. [, W it. <br /> � <br /> _✓ .-� . <br /> Approved Bp- i<,. --•. _ <br />•.,. Ciry Enpineer j:� � <br />� . i. ;% <br />` Issued By ^ • �-•='"'- <br /> Inspection 9y <br /> Datelnspected <br /> 0 <br /> SEE SKETCH ATTACHED rvo. 2 2 4 6 5 <br /> WSPECTfON <br /> i <br /> I <br />