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, i <br /> ;;� CI�*�1T NO. <br /> i <br /> everett � <br /> , <br /> e ..�: � <br /> .�_ <br /> �. <br /> City of Everett `� , <br /> Engineering & Community Services <br /> ' Sewer Application and Permit � _ <br /> ' N0. ZZ5H7 DATE ���� � �-���' <br /> � ' �'.., �� n�';; ,rt_ t L�_�C.. Utility Account No. ' . - <: ' �_ - l d ' ,. � r_' •..• <br /> ' Service Address � Z-' .,y.� t: tU <br /> -- Z L�:. C-�c ,••,r•,�i . �_� �> c_ PermitFee � <br /> ! BillingAddress � c:G; / <br /> < , -. '- �_ . F'r� `/�'r:7t�� <br /> City, State, Zip �-- �' �--�`L'�r �.V�� i< . < � Connection Charge(s) <br /> �U � U <br /> � Owner �Mortgagor) ( t�� � > > i ���� �" � � Total Fee <br /> Billing Name � � ' �` � �� 1 �'� �'��_- 1 .� 1 <br /> Connection By . ����."'�� � ' ' ! 1 <br /> � � ' � d L l.� �� 1 ,V�.. Signed � ;i.'; i I 1 � — <br /> AdC�fBSS — "� -- Customer . <br /> Phone " `"IZ.'-I�'� �� <br /> � �� I,.;�.ti),.. � I <br /> DESCRIPTION: Sewer District t <br /> . '4 ��U � <br /> Lot Block � � Monthly Sewer Service j <br /> Plat F. i_., �_ i_ � -_ �-,—i� ��,'� �`^."—^. � <br /> Unplatted Description �' ���' �- `" ` 1.. =' ` ��:L :��� Monthly Sewer Constr. a <br /> , � -�-. .�., �_�� r _ ' .tc_;� . l�.LC � ��.F '�_— <br /> L_�_�'_�'�_ � Trunk � <br /> Type Permit: '' `� �- �--��-. 5.: �_t_ � �1 <br /> Lateral � `` � <br /> �� La.A_��J�-� � � , <br /> Remarks: Abutting Lot Line i <br /> N, S, E, W ft. � <br /> � <br /> � � <br /> ApProved By � � 1��.�,.�t ti �-� _ � <br /> City E�B��ccr <br /> IssuedBY `-� � ; '. ! r. �1 � �: � ;CJ i <br /> Inspection By <br /> Date Inspected <br /> � SEC SKETCH ATTACHED No. 2 2 5�7 <br /> INSPECTION � <br /> M_ �_.. ��,:� _ - --.� _ - <br />