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_i <br /> CHART N0. � � �- � �� ' -� – <br /> everett •- ^ <br /> �U 5�� <br /> � Jj <br /> City if Everett /v�� �/�� 1 <br /> Sewer Application and Permit �� � <br /> � <br /> � <br /> � <br /> No. 23199 DATE ' <br /> Service Address Utility Account No. <br /> Billing Address Permit Fee i I <br /> Ciry, State, Zip Connection Charge�s) i <br /> Owner (Mortgagor) _ Total Fce <br /> � <br /> i I <br /> Billing Name I <br /> i <br /> Connection By � � <br /> Address Signed � <br /> Cuslomcr �i <br /> Phone i <br /> DESCRIPTION: Sewer District � , <br /> Lot Block Monthly Sewer Service — , <br /> Plat � <br /> Unptatted Description Monthly Sewer Constr. <br /> – — Trunk I <br /> ; Type PermiL , <br /> ILateral <br /> Remarks: Abutting Lot Line � <br /> �.. �i�l J�� �-- � N, S, E, W ft. � <br /> r , � <br /> /%', r , u. �/� � % rii. _ �/<< . � , <br /> I �� � _` �.. ��, !'] �! '. j' I ( � -: f � � <br /> — Approved By <br /> Ciry Enginocr ' <br /> Issued By , <br /> � � <br /> � � � <br /> Inspection By —�� _ ���'� ' ' " �' � ' <br /> — � <br /> Date Inspected " �"�� ' �� i <br /> SEE SKETCH ATTACHED No� 23199 <br /> INSPFCTIOfd �I <br /> ii _ <br /> I <br /> 1� � <br />