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� ;.x �!��� n CHART NO. <br /> �'_ .S �R_S <br /> :C _ .� C <br /> everett �- • � r <br /> � r��iJ�:�. <br /> � L L�� i �i <br /> 1 - z. : , <br /> City of Everett <br /> �'i <br /> Sewer Application and Permit �� `� <br /> N0. L��ZS DATE �/�7�9 <br /> Service Address_ ��O � ( -�'�N�rt� Utility Account No. <br /> � c� <br /> Billing Address - Permit Fee a <br /> City, State, Zip / Connection Chargels) _ <br /> /> /�� �> /���/ /� a=r <br /> Owner (Mortgagor��( n �n ��l�� Total Fee / <br /> Biliing Name <br /> Connection By - <br /> Address Signed <br /> Cuslomcr <br /> Phone 3�3 — �O � � <br /> DESCRI?TION: Sewer District ___ _ —_ <br /> Lot �n - ' r Biock � �� <br /> =z���� -7f�n / .y Monthly Sewer Seivice <br /> Plat �C �u / ��5, <br /> Unplatted Description �— Monthly Sewer Constr. <br /> Trunk <br /> Type Permit: <br /> Lateral <br /> Remarks: <br /> Abut[ing Lot Lin� <br /> N N, S, E, W ft. � <br /> �-A5�ic E(��Acin/ oLp ccn , <br /> Approved BY <br /> citv e�pi�cor <br /> iC�A1 �0 • U 0 �Z'a SJIFR�C�_ � i o� <br /> Issued By <br /> Inspection By� "� � <br /> Datelnspected 0 �29 " �• <br /> SEE SKETCH ATTACHED N0. 232ZS <br /> W51'I:CIION <br />