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�l <br /> � <br /> I� <br /> CHART NO. <br /> evereH <br /> e <br /> City of Everett <br /> Sewer Application and Permit <br /> NO. ZG.J�c�.a. DATE ��/%9�� o <br /> c <br /> p� �1-� m <br /> Service Address ��� a ' ✓.S,L �-��r �"�Utility Account No. " <br /> �J � �0 "�� .� �, <br /> Billing Address_J �a � ��'"T'-�'�\ �'Ur� ' Permit Fee "� T <br /> �. -i <br /> - N = <br /> City,State, Zip 2- � �y Connection Charge�s) c o <br /> ` � -- m o <br /> Owner (Mortgagor) Total Fee 3' � 0 3 <br /> m <br /> -� z <br /> Billing Name m "+ <br /> .o z <br /> Connection By . <br /> a -+ <br /> rx <br /> Address Signed ' � -'-��� i ��i, <br /> Customer < T <br /> Phone � 3 <br /> -� m <br /> DESCRIPTION: Sewer District m .-� <br /> � <br /> Lot� lock _ Monthly Sewer Service � m <br /> Plat � � � <br /> C N <br /> ; N <br /> Unplatted Descri ion Monthly Sewer Constr. �� <br /> . m <br /> Trunk A <br /> Type Permit: ;e,�. � <br /> Lateral = <br /> a <br /> z <br /> Remarks: -' <br /> -'"�" Abutting Lot Line = <br /> � aZ � - N, S, E, W ft. N <br /> z <br /> 0 <br /> -� <br /> � <br /> Approved By �- ✓�. ��'�� m <br /> C�ry Engineer <br /> IMPORTANT! �' ��� <br /> Issued By Z_ <br /> CALL 1�800-024•5555 48•HOURS <br /> PRIOR TO DIGGING � <br /> CALL 259�8811 FOR INSPECTION /� I <br /> Inspection � Vade�i�G,N I <br /> �ate Inspected /�8 ' �� <br /> SEE SKETCH ATTACHED Np, G5.�Z�' <br /> INSPECTION <br />