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r3- �� ;�- / i <br /> CHART NO.� � I <br /> everett ; <br /> //��� � <br /> � ,.: __ C : <br /> City of Everett � ���z �� ' <br /> Engineering & Community Services <br /> Sewer Application and Perrr9it � : <br /> , , <br /> N0. '.(' ,, ) � !� DATE �4����j� , <br /> � <br /> �� � <br /> Service Addresc iy �� �'_---' - .<-,- : J ���Y/ Utility Account No. 1 � <br /> l i` G/ � � <br /> Bi�lingAddress �� Sf �/• f�� �•1 PermitFee �� � <br /> � a`� -�, :'�.r' J : _�,�!` � <br /> City, State, Zip..-- 'r'> %- r/-lC- ./..;1� • i,'. (-. Connection Charge(s) <br /> � �G ' <br /> Owner (Mortgagor�_,r�i�- . -��;�-''",�.:--�i. Total Fee_ w � � i <br /> . i <br /> BillingName. - ,� :%f �=�,,,;., .,��. -1 �-,� . I . <br /> , • i <br /> Connection By . ' �� , i ,��, : 'i. . _ � i �;:-� Ce{ . � � <br /> � : � .. ��, �� <br /> Address_ �� � ' '�' � � � 1� �FG��gned 11' <br /> ' " v <br /> /(,::.r� . . .. -C'r,-• �� <br /> Customer � <br /> t <br /> Phone i'�t. �•,'7 ��/ '%'7... - <br /> DESCRIPTION: Sewer District_ <br /> �-„� <br /> P at Blocic - Month�y Sewer Service -%� •- �` <br /> Unplatted Description -��c'-r� . ,L.h ;�- � �'k 'l• Monthly Sewer Constr. <br /> ;��s;_�. �/ r!G' � . <br /> Trunk I <br /> Type Permit:;�f,. ,.� (J�_., .' � <br /> '` "�. - • Lateral_ � <br /> Remarks: <br /> — Abutting Lo: Line <br /> N, S, �, W ft. <br /> ,:_.".... <br /> � . <br /> -- — APProved B� . ! . c. ; - <br /> Ciry Engineer <br /> r.;. � .:.' . <br /> � i .- <br /> Issued By_ '" - ` --.-'"'-r:- � 1 <br /> - - � � <br /> _ C �Inspection S <br /> iDatelnspected� � �_ � <br /> :� <br /> SEt SN.[TCH ATTACHED N0. � �� '. � <br /> 1rlSPLCTION I <br /> � � �� 4 � <br /> _._ J��Y:���iLti--`:.u:�. _..'�1P _ Pf_71W.� �.7_ _ .�F_..'._��... ., .;.n'��.�.�_. . . <br /> 1 <br />