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CHART NO. — <br /> Rverett <br /> ;� <br /> � ' vv�� <br /> 7 <br /> City of Everett '� <br /> .�,�,, <br /> Sewer �4pplication and Permit �-1 <br /> �� �� <br /> NO. Z31SO DATE / -- <br /> , .- <br /> �: � �� � <br /> - -� � .� -}=, '�i';•,rn �,-,��;� UtilityAccountNo. � <br /> Service Address ;`` <br /> Billing Address Permit Fee <br /> City, State, Zip Connection Charge(s) <br /> Owncr (Mortyayor) Total Fee — <br /> Billing Name <br /> Cor�nection By <br /> Address Signed — <br /> Customcr <br /> Phone <br /> DESCRIPT�N: Sewer District _—_ <br /> Lot � j� Block <br /> Monthly Sewer Service — <br /> Plat <br /> Unplatted Description Monthly Sewer Constr. <br /> — � — Trunk <br /> Type Permit: <br /> � <br /> Lateral <br /> Remarks: l� <br /> Abutting Lot Line <br /> N, S, [, VV ft, <br /> -- � Approved By — <br /> �Q J J� CiryEngineer <br /> Issued By <br /> �... <br /> / /' : � <br /> Inspection By ��Y� ` �" ��==— <br /> Date I nspected � +�— / � � <br /> SEE SKETCH ATTACHED NO. Z�1StJ <br /> �I�!� . i._[,�� I:,� <br />