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' ' CHPRI' NO. <br /> everett' • , ' � ` • <br /> � . <br /> City of Everett <br /> Seonrer A�apl�ccatiQn and Permft s, <br /> � . <br /> NO. 23Z�7 DATE �/' l/� '/ --- <br /> Service Address���t��.��__���� !�-G�11 $f�1` Ulility AccoUnt No. �� g �� <br /> .l�-�` <br /> -J' /� 3n <br /> Billin9 Address ��� '2 P� ��ti'�� .5�� Permit Fec - <br /> /� o�� <br /> City, State, Zip,r_�_..1.-F�� ��� _ ���Q � ConnecNon Chargels) ���� <br /> 9 i - , _ <br /> ,; - <br /> Owner (Mortgagorj �'-� ` ' . -' C,��' Tc. ,I Pcc__ � ' ' <br /> Billing Name -+� _ <br /> Connaction By _ <br /> ,Y.' <br /> P.ddress— Signei}. _ . i:.� , --- - -- <br /> — ' cusiinn��� — <br /> Phnne iS'==���:==�. • <br /> DESC.RIP'iION: Sewer District____�:_ _T__- <br /> Lot __� //_ Block_ <br /> '�--- Monthly Sewer Survi:e �• � U <br /> Plat ,',.0 - -� .. 1y_/ �.�f_<„-✓ _ <br /> Unplatted D�scription Monthly Sewer ConsV. <br /> — ' Trunk ,/l - -?0 /D�.00 <br /> Ty���, Pennit: ���vf/`_ -/ -� _ - <br /> Lateral <br /> Remarks: <br /> — — Abuttirn{ Lirt Line <br /> N, S, t. tiV.-- -------------ft. <br /> — — ,, ,% �, <br /> j - : �/ APProved f3v •�/ ' G�//-��=�:� <br /> � � '/ G.�,,.�iv ' .�c-I /'�!_Po�r-�.C�- (�jriG�/ GIY Engmeer <br /> t <br /> l'�/� �l- �' � 6�O �'-J � � <br /> -�'r iss�,��d ttY.- -- -"=—�L <br /> - — i�,sF����:u,,�, �iti-- — _ _------- — <br /> _ _ _ Date Inspected-- ---- —_—_-- <br /> E:[E SKETCH ATTACHED ND• 232�7 <br />