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CHART N0.!'���S <br /> evereri <br /> i , <br /> � , '/ �'J s r'n . ' <br /> 1a -i8 �- ,, <br /> City of Everett <br /> Sewer Application cind Perrr�it <br /> No. 23317 DATE � -' �1 <br /> Service Address � % Utility Account No. <br /> Billing Address Permit Fee - <br /> City, State, Zip_ Connection Chargels) <br /> O��ner (Mortgagor) Total Fee _ <br /> Billing Name <br /> � _.�,- <br /> � ; � ; � <br /> Connection By , • ' _ <br /> F_ <br /> Address / " __ Siyned <br /> C�islomcr <br /> Phone <br /> DESCRIPTION: Sewer District <br /> Lot Block <br /> Monthiy Sewer Service_ <br /> Plat <br /> Unplatted Description _Monthly Sewer Constr. <br /> — Trunk <br /> Type Permit: ' � � % <br /> Lateral <br /> Remarks: �, 7�n L - ,r r� � /, '" _<' ;" <br /> Abutting Lot Line <br /> ,�rj�/� ; f „r�.., � . '. .� f �� i . N, S, E, W ft. <br /> �a., l` ,�- //L / . : <br /> — Approved By � <br /> - � City Enginecr <br /> Issued By " / <br /> Inspection By �-�� �� ;�� Jn ' " � ( � <br /> Datelnspected �' % �- �% <br /> SEE SKETCH ATTACHED No. 23327 <br /> IH;PECTIOM <br />