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' CHART N0. � <br /> everett <br /> e �'� � ' <br /> \�� � � �� 7 �j <br /> City of Everett � <br /> Engineering & Community Services <br /> Sewer Application and Permit <br /> rvo. 2272G DATE �/ � <br /> Service Address '��� - � ' Utility Account No. <br /> ;�_�- <br /> Billing Address �'�'�- � _ '% '��� Permit Fee 1 ;� <br /> City, State, Zip - - ' ✓�= • "�'�._ � � Connection Charge�s) - <br /> , �� <br /> r - " i <br /> Owner (Mortgagor) � -. f ' Total Fee ' ' <br /> Billing Name �-" <br /> Connection By � <br /> _ � <br /> Address Signed <br /> Customer � <br /> Phone J � � /� J � I <br /> DESCRIPTIO[y; Sewer District �`/ � ��- ; <br /> Lat":� %��' Block � MonthlySewerService " ' � ', <br /> Plat _ � <br /> � <br /> Unplatted Description Monthly Sewer Constr. � <br /> Type Permit: Trunk j <br /> I <br /> Lateral <br /> Remarks: <br /> Abutting Lot Line <br /> N, S, E, W ft. i <br /> � � <br /> Approved By . .'% <br /> Clry EnOineer <br /> Issued By % � <br /> Inspection By <br /> Date Inspected <br /> � <br /> SEE SKETCH ATTACHED NO. <br /> INSPECTION <br />