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L�o, J4L ,� <br /> i CHART N0. ` � �' �' <br /> everett ! <br /> �' � � ...`' '� � ;._ <br /> � � S � <br /> ; <br /> i `, <br /> � i.. <br /> � City of Everett _,_ <br /> � �ngineering & Communit,� Service� <br /> . - <br /> � S�ewer Application and Permit : <br /> � no. � l i �) ^; DAT[ q �•� r� <br /> i - -� <br /> fService Address �� ��r L��- C.1JCli�'(.%G /�UL( Utility Account No.'-.�` ��=� - �-'Z•1" �-> 1 <br /> f Billi�gAddressY- Q •f'��C �'Z- � �'�� " �U <br /> Permit Fee -.� <br /> • City.State, Zip�vE7-' �r� ZL (.o � C r- C?C.� �J�� Q � (�J7 <br /> �7'�"" Connection Charae(s) �'� .-> • <br /> T— <br /> ,/ � / C�[':t.=_.i 11. '?-. ��, CC., <br /> ' Owner (Mortgagor/—Y-v�li' �( �t/�t/Ge, Total Fee .0 _� <br /> �, � ., <br /> Biliing Nam�-�+�h•/� .-� <br /> i �._ r � 1 <br /> Connection By ���'ti �L- � \f <br /> ` �� s <br /> � Address�`) �-I'� �'.-•�K •� � � Signed `� C�:i mer <br /> � Phone f�� �� � L � ( � �- <br /> � DESCflIIPTION: Sewer District �- � ��-'L''�`' '� � <br /> i Lot���1� ��L-' Block <br /> I Plat '�'�.��-Tr �-�?�L.G. `_.� Mouchly Sewer Service �/�r-T'L.�t�, � <br /> I Unplatted Description Monihly Sewer Constr. <br /> 1 <br /> f Type Permit: .� � Trunk �.. • �=�.� <br /> �_"� / ;G� �C C':i = 1 <br /> iLateral ! 1��~ <br /> Remarks: , <br /> ' — Abutting Lot L�i 1e ,� <br /> i N, S, K�W� � � ft. <br /> I <br /> ! /// <br /> ' APProved By�, f--tE--�''C-1/,(�'�/ <br /> � City Enginecr � <br /> CIssued By �� LL 1 J��/l� <br /> i <br /> i <br /> r <br /> � Inspection By c� !��.n�Li-J <br /> IDate Inspected�/�7� <br /> I � , <br /> � SEE SKETCH ATTACHED N0. , ': <br /> i ,.�, - � �fdSPECTIOpI ,��� ��, � <br /> , } _ _ . , � <br /> � 4 . <br /> � <br /> � ,� s ,�:; ; . <br /> , f -.. r-.. .,,.. ., ? <br /> � _ . . _ _ _ _. <br /> —+ec� _,.. <br />