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� <br /> �_ �1 <br /> CHART N0. <br /> everett <br /> e ;o ��o� F� <br /> C.s%o�Ti,�/�'i /-3 -8c <br /> City of Everett <br /> Sewer Application and Permit � <br /> ., <br /> � <br /> m <br /> N0. Z544Z DATE ����C.� .. <br /> �. ... <br /> -� � <br /> ��-��/ � ., �' <br /> Service Address� ��' D� h Utility Account No. �' m <br /> 0 <br /> Billing Addres�e . �`"� r��n�'+-��- Permit Fee L�� ��` m g <br /> � o <br /> City,State, Zip -' � �._ Connection Charge�s) _� <br /> >/� m <br /> Owner (Mortgagor) - Totat Fee J(,.1 � � �z <br /> Billing Name v��- r <br /> .. .. <br /> <y <br /> ConnectionBy� - ✓G��T/�- �a <br /> Address f'TbB✓ '� Signed ,_._.!`.. "'- c�mn,�. ``".Tr�--'—___ m� <br /> �--c� �/' N <br /> Phone r-�S3 �.Z_�-S <br /> c�i m <br /> C N <br /> DESCRIPTION: Sewer District r�, �" <br /> zn <br /> Lot Block � m <br /> Monthly Sewer Service D <br /> Plat — A <br /> Unplatted Description Monthly Sewer Constr. _ <br /> a <br /> z <br /> Trunk .� <br /> Type Permit: _ <br /> .. <br /> Laterel �' <br /> z <br /> 0 <br /> Remarks: -+ <br /> Abutting Lot Line � <br /> N, S, E, W ft• r" <br /> Approved By �'/- " l " ��� <br /> Ciry Engineel <br /> IMPORTANT! _ � <br /> Issued By <br /> CALL 1�00�424•5555 48-HOURS <br /> PRIOR TO DIGGING <br /> CALL 259-6817 FOR INSPECTION / * <br /> Inspection By <br /> Date Inspected � /�/�� <br /> SEE SKETCH ATTACHED No. 25442 <br /> INSPECTION <br />