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. . " ". �".t1�. r . <br /> ` � CHART NO.� �- ' �- '' � <br /> everett �d�p"`�� ��� _, <br /> � �, � ' <br /> e = �w: <br /> ► . �. . <br /> City of Everett I <br /> Engineering & Community Services „. <br /> Se��ver Application and Permit � <br /> N0. �' ) � J �l DATE r/� /� % <br /> � Service Address r'" I �� P f ' ` �'```" � '''''"�• Utility Account No. � — �'6 ` � 7-? - tl0 <br /> J <br /> C�' ` ��O l <br /> BillingAddress 1a=' '�-S �/ - . �"' f PermitFee � � <br /> U, �� <br /> '�� ? ` PD�f� Connection Char e ^"��� <br /> City,State, Zip / _::,t>L' v-=<v, .,•l/�tr. ��, 9 (L)� <br /> Owner (Mortgagor) �`~� ' ' �� `-�•" ` � • Total Fee J� <br /> : <br /> i <br /> Biliing Name =�-t-'' ��--�' <br /> Connection By -- `''-r -�--� � ' <br /> Address Signed %7 e //!�'��� ��1��°�!rr c.- <br /> Cusromer <br /> 7 'J.% ' � J � � � <br /> Phone , <br /> � <br /> DESCRIPTION: SewerDistrict -�F' �- -� ' <br /> Lot 1 � `� Block�— r . �o � <br /> . , Monthly Sewer Service <br /> Plat �-. yf/�:.•.-_..' - <br /> Unplatted Descript' n Monthly Sewer Constr. j <br /> � � <br /> � Trunk �•�-'� <br /> Type Permit: '.?J... -� /' '� . � _, L ' �% I <br /> Lateral <br /> Remarks: ' <br /> Abutting Lot Line , <br /> N g E, W ft. i <br /> � : �, �/� . �� <br /> '�(j �!-• ' :.�� <br /> Approved By <br /> � City Engineer J' <br /> IIssued By <br /> { <br /> � nf� r <br /> � Inspection By_11`�•��"�� <br /> � ���� � <br /> i <br /> Date Inspected <br /> I <br /> 9 <br /> � SEE SKETCH ATTACHED N0. _ - <br /> � <br /> I i IPISPFCTIO�I <br /> � <br />