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everett <br />� <br />City of Everett <br />Engineering & Community Services <br />� <br />CHARTNO. �' ��-�-�F"� <br />, ; �; - - <br />r . _. <br />;�� �7-�P �/zL/,y� �: <br />.,� �� �-�a-� <br />5ewer Application and P�rmit <br />rvo. "�`'1 �'o- ���- / <br />.._ e_ �_� I � DATE <br />Service Address '' �f� � ' - - ' ' %-° <br />Billing Address <br />.�i,:"'/y ,; ./: �,�.; ! <br />CitY, State, Zip %��:" l� C; l' /�/� '/5 <br />Owner (Mortgagor) �- ' ' ' <br />� <br />Con�iectian <br />�-- <br />_ _ . �- <br />Utility Account No <br />Permit Fee �� d '"�� <br />Connection Charge�s) � J/� l�—_ <br />��� <br />Total Fee J �% <br />Sign <br />�-, <br />�-� . <br />�' / yen�'S <br />- �7IoI y/7C, <br />Phone ��/ % � <" ': � � n. ',� � „�� � / �. � <br />' �/ <br />� � �'`-� � T�1 <br />DESCRIPTION: Sewer District > ! <br />Lot "`" <br />Block J <br />Plat Monthly Sewer Service � %� �' � <br />Unplatted Description � �� '=' i- � Monthly Sewer Constr. <br />SEE SKETCH ATTACHED <br />�T`si.r� Q+'Ofi%�;.?'e'.,� —� ��'!`.;� �_�:I�t_)f`I <br />' x <br />�,�.. �Y.i�:�._1f31!� s�Ch_.L_��~ . .. _... <br />Trunk l � /.=: %I j �' <br />`� / � <br />Lateral �. ; � %: �� . <br />Abutting Lot Li�n ; <br />N• S, E�`Cy� �^� �' t� ft. I <br />,f-�i �./ • <br />Approved B�/ . / .�"- <br />- Crty Engineer <br />— �• <br />Issued By '' ( <br />'�, - <br />. • . /�!/// <br />�. ,- •, <br />'. �".;.-'�. r �;i'�• p``�i `;,' + F,\ <br />ti^a.i `L� .� ��i! t , � .� `f: ,S <br />\ <br />� <br />