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CHART N0.— I\ .��- Z �l ' S' <br /> everett <br /> -� <br /> � '� / <br /> 1 �s ��/. <br /> ; _ � .. -� �� <br /> City of Everett ��' <br /> �. .. <br /> , .- ,�._ <br /> i 'i -� <br /> Sew�r .l�pplieation and Permit - <br /> NO. CZ99:� DATE � — <br /> Service Address L �ll �u Utility Accoimt No. <br /> Billing Address _ Permit Fee_ �d <br /> City, State, Zip � _ Connection Charge(s) <br /> Owner (Mortgagor) Total Fee �d <br /> Billing Name <br /> Connection By <br /> Address _ Siyned_ <br /> Cuslomer <br /> Phone <br /> DESCRIPT N: Sewer District___ <br /> Lot�`�_� Block_�_ � <br /> Plat Monthly Sewer Cervice � <br /> Unplatted Description Munthly Sewer Constr. <br /> Type Permit: Trunk <br /> Lateral � <br /> Remarks: �� G 5 <br /> Abutting Lot Line <br /> N, S, E, W ___ ft. <br /> Approved By <br /> Ciry Enginecr <br /> Issued By ___ <br /> Inspection By '—c?'�try \ '��/ `� <br /> — Date I nspected � - ��� ' 7q <br /> SEE SKETCH ATTACHED No� 22999 <br /> INSPKTIGN <br />