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CHART N0. S"7'ag"S <br /> everett -- <br /> � �� � � � <br /> � ��,�� ��, <br /> ''�; <br /> City of Everett � `' �`� ?�� <br /> Sewer App�ication and Permit <br /> No. 23086 DATE <br /> . , <br /> Service Address ����� �i,��'-,'� �i �<< i���;�� Utility Account No. <br /> Billing Address Permit Fee <br /> City, State, Zip i� Connection Charge�s)_ <br /> � - " <br /> Owner (Mortgagor) Total Fee <br /> Billing Name <br /> Connection By_ - <br /> Address �ig;�e� <br /> customer <br /> Phone_ <br /> DESCRiPTION: Sewer District_ <br /> Lot Block_ <br /> Plat _ Monthly Sewer Service <br /> Unplatted Descriptiori Monthly Sewer Constr. <br /> Type Permit: Trunk <br /> Lateral <br /> Remarks: <br /> Abutting Lot Line <br /> N, S, E, W ft. <br /> / ,. <br /> �� � K APP�oved By <br /> Ciry Engincer <br /> _ % <br /> Issued By _ �_ <br /> r <br /> % <br /> Inspectian By ��%'�`<���� ��"�` �� <br /> �, � <br /> Date Inspected �L� �-5 � <br /> SEE SKE"fCH ATTACHED N0. Z�OH� <br /> IN:;PEC1lGIJ <br />