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. . <br /> _ � . <br /> everett CHART NO���R���' <br /> l <br /> e �osT�.v ! <br /> City of Everett �1 �� � V <br /> FrgineP-in� & C�m��i�nity Services � <br /> Sewer Appiication and Permit � <br /> � <br /> , <br /> NO. F�L .� O J DATE � � <br /> /'-. � ' /�•� � � <br /> Service Address —� , , ' <br /> ��-- �. ,,,_` ,_�y ; � Utility Account No. <br /> Billing Address_ ' '� Parmit Fee _ ,2 =r� <br /> J r.. � f� � —"—�—lC.�'-. i L2 �. . <br /> City, State, Zip • ` �= _. Connection Charge(s)_ ,�---' <br /> " ., „;j;r� . � ..�, <br /> Owner (Mortgagor) — : Total Fee �° <br /> '--- ':_�t, -..v - <br /> /,_ _ / _ <br /> Billing Name ✓ ;�` � <br /> - _ �� � <br /> Cannection By ' <br /> -�: �- . -c'-� ._-,.�j-_ . <br /> Address_-: --; �-, �� ; <br /> J. � � _ �. . f „ c���9_4e. . ` .�.S• ; C._�_, ..--. <br /> � Customer �. <br /> Phone - !� l� J�r/zs' -- ---' <br /> .1^ :�'- . �� � � � <br /> DESCRIPTION: y Sewer District <br /> Lot�_ glock�_ � <br /> Plat _ Monthly Sewer Service <br /> Unplatted escription� '� ' <br /> Monthly Sewer Constr. <br /> Type Permit: Trunk <br /> .; ;�.. .� <br /> Lateral <br /> Remarkr. <br /> Abutting Lot Line <br /> N, S, E, W ft. <br /> f — <br /> Approved By ---- ' <br /> . .. ci{vtE inou . . <br /> Issued By .s� ' '' . <br /> '�- f=;�, <br /> Inspection By �- R <br /> � Datelnspected �J/ <br /> SEESKETCH ATTACHED <br /> INSPECYION �� <br /> � � � ' <br />