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CHART NO, ,."l'' L��� 3 <br /> everett { <br /> ,%� S / � /� ; � <br /> � � _ � <br /> City of Everett �/��7 � � — � � i <br /> Engineering & Community Services "�, /`C � �C_ , <br /> ✓ � <br /> Sewer �4pplication and Permit ' <br /> . n -� - DATE ��" /�' i '' �'�-"_� <br /> NO. � C � � 2 . � <br /> Service Address � f ��'y'� � `� �'�- � ' c� r.-� Utility Account No. <br /> Billi�g Address � • ���' '1- �`� � � `� Permit Fee - <br /> City, State, Zip '�=-f��C �iti�•:J �L•� -'' ` = - Connection Charge(s) <br /> Owner IMortgagor) �� ��'� � "`��L `'�' - �" "� - Total Fee ', <br /> Billing Name �'�� �-��- <br /> Connection By �..-� �% .C;-_= f_=...L-'.-'r.�; >'- <br /> ; <br /> Signed L c=.G i ` �'�e,: i. `�':>r i :i: � , <br /> AddfB55 Customer ' <br /> Phone <br /> DESCRIPTION: Sewer �istrict <br /> Lot Block Monthly Sewer Service <br /> Piat_ - <br /> Unplatted Description 4";� ..�.�.� ;_ � .= `'� ' (`-� i1 '�� ti Monthiy Sewer Constr. <br /> Trunk + i <br /> Type Permit: j�.. L_i.cJ �--/�i���-r:� � � <br /> Lateral � <br /> Remarks: ^ � <br /> ��t,CLc i� ��.�-�" �' �`-�ti�a- Abutting Lot Line <br /> iy ' , /� � f � -lrr_ci-- N, S, E, W ft. <br /> /� `/ , .� /� <br /> (..c.-C-C� � ? T �'�c'7w /�. /�i6�' <br /> r / . .�CC-��'G <br /> _ ln[L !ccd <br /> Approved By � ���-- '�- �"'�'-! <br /> City Enginecr <br /> Issued By ��-- �,'-I <.-G �.t :.J ; i .✓ <br /> , <br /> Inspection By °�''�'� <br /> Date Inspected_____�' 70 <br /> 0 _ :7 <br /> SEESKETCH ATTACHED NO. __ <br /> i ,c i'�i�i>i <br /> � �_. , � <br /> � � � `� -. <br /> - :.. . .. .,:� c.I�' •��_ . ,`.<��:.� <br /> ;': �� .,. .� : ,,., ..-.. . . � . . . .... , '.'; r ,".�: .. . .. _ .-_ ='_- ,.`---- - <br /> ,�,.; , : , ,.� ,..... . . . . . . .-... . ... <br /> �.... . . .. . ._ .. <br />