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� <br /> � CHART N0. <br /> Ieverett <br /> � e <br /> _� <br /> City of Everett <br /> S�wer Application and Persn�t <br /> No. 24939 DATE � <br /> Service Address��v� VF'l-TY� Utility Account No._ <br /> Billing Address Permit Fee "--�� <br /> City, State, Zip Connection Charge(s) <br /> Owner (Mortgagor) ' Total Fee �y <br /> Billing Name - <br /> � --- <br /> Connectiun By ' <br /> �i. , i- , �..�. . <br /> : � •1 i - , � _ � • } Signed .,:- . . _ � <br /> F�dd�C55_ Gusromer��� � / <br /> Phone � <br /> DESCRIPTION: Sewer District <br /> Lo[ Block Manthly Sewer Service_ <br /> Plat <br /> Unplatted Description � S� � � Monihly Sewer Constr. <br /> � i <br /> , � <br /> � — Trunk <br /> Type Permit: � <br /> Lateral <br /> Remarks: <br /> Abutting Lot Line <br /> N, S, E, W ft. <br /> I - Approved BY <br /> Ciry Enpineer <br /> � Issued By ' <br /> , Inspection�� �` � <br /> Date Inspected �- '��-� � <br /> ' SEE SKETCH ATTACHED NO. ����9 I <br /> I <br /> INSPECTION � <br /> .'_ <br /> � <br />