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_ - �yd�'�"'� �°,.r'" . <br /> Y� "��; <br /> ..�. .. .. . .���. ., . <br /> :°!^ A`�'� `�� . <br /> �'; eve-rett CHART NO. S�I� '2�-`{% ' <br /> � , f <br /> `� � /�e � ✓�� � <br /> �'' � 8•�-- 7� <br /> �� <br /> City of Everett � <br /> , ,��'�( _ � <br /> � Engineering & Community Services <br />�° ��r.� � Sew�r Application and Permit � �: � <br /> , ., � . � <br /> / � <br /> {Y 4�J� <br /> '�,P9 ` N0. `� � 3 � a� DATE J/I� /%� 1 <br /> r < i < <br /> '7fei'�> 1 T-' I <br /> a p = . .�� � / i. <br /> �}� .�� 1 - ' . <br /> '` Service Address F��' `—' �- �:-���.-f.-✓ .�-"-�� Utility Account No.3" ��.�u �` �� �� i <br /> 1/��% "' �!- i <br /> H ' Billing Address r�� �' �� ' Permit Fee_ J D <br /> , r y „ City, State, Zip-t-� -- r(ii . .��- �-}'�%� Connection Charge�s) �4 � � <br /> � I <br /> ,� <br /> �,/� c <br /> �!v, r- Owner (Mortgagor�_'�``�'rr�`�� ''� � '"T""r; : =✓ Total Fee �D ✓ � <br /> 3 � .� ,� _ <br /> � ��; � 1 i <br /> �" Billing Narne _/�_;.�' -��-L.� ;� i <br /> 3 .. !' , t ��� � <br /> ��r - . � � '� <br /> Y� S Connectiai By ./�?r<-,- �..�-- . � <br /> �r� . i „-:-'' 1 <br /> f ' Address � , '� � <br /> , � ; Signedy ''� ' <br /> �P�;, , .. , Customer � <br /> %- I <br />�p�� � Phone �� � - -�v � �= ,.�"'^� j <br /> n p _ 'r . , <br /> ?' ` DESCRIPTION: SewerDistrict�? i.—..'•, � � i <br />� � y ., <br /> Lot Block � ^ ✓ Monthly 5ewer Service ^�' T U 1 <br /> PIaU' ✓ — <br /> Unplatted Description Monthly Sewer Constr. � <br /> Type Permit: .•;C- � i' �.,_.; _ �; _ ` Trunk :�• `'U _ ' <br /> � � <br /> Lateral <br /> i <br /> Remarks: <br /> Abutting Lot Line � <br /> N, S, E, W ft. ; <br /> � . i <br /> Approved Bj( �.-T-:r.; � <br /> CiryEngineer � /� i <br /> / L � / / � <br /> �!. <br /> Issued By •^ • . 1.F-.z.i � <br /> I <br /> 1 <br /> Inspection By 74'/�.v--L � <br /> i <br /> Datelnspected (� — Z 3— � i <br /> a � <br /> � <br /> SEE SKETCH ATTACHED N0. � cl :' � :� � <br /> y r �sr-: c nori � <br /> . <br /> �- °-� <br /> . .. .,:. � ., . _ , <br /> s : , ,_ . . <br />