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, . , <br /> CHART N0. <br /> everett <br /> e <br /> City of Everett <br /> Sewer Application and Permit <br /> NO. 2�358 �ATE ��- �— { 9 <br /> � -�!(Nity Account No. D <br /> Service Address s — � <br /> �rnit Fee�— — <br /> Billing Address <br /> City,State, Zip /• `'"''%' Connection Chargels) <br /> � 03 otal Fee �0, �' <br /> pwner (Mortgagor) <br /> Billing Name <br /> i <br /> Connection By ---' � <br /> ./.. ,,' . <br /> I Address _ Signed c�s�o�++e� <br /> ?hone �S/''—� ���_' <br /> IDESCRIPTI : Sewer District 3� <br /> Lot Block Monthly Sewer Service ���� <br /> Plat��� <br /> Unplatted Description Monthly Sewer Constr. <br /> Trunk <br /> Type Permit: <br /> — Lateral I <br /> Remarks: Abutting Lot Line <br /> N S E W ft. <br /> , <br /> � � <br /> — Y I <br /> � u Approved By �/CiryEngineer <br /> Issued Bv —1 <br /> r � Inspection By <br /> ' Datelnspected <br /> SEE SKETCH ATTACHEU <br /> No. 23356 <br /> INSPECTION <br />