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_.. _�. _ <br /> �� <br /> •� - j -%� ' CHART N0. � S Z$�S <br /> everett <br /> e � <br /> City of Evarett � c# �' �n/, S, �. <br /> P�� L � � <br /> Sewer Application and Permit <br /> N0. 23310 D:+TE y��J <br /> SerOice Addreu ���� �r�.d'��"� L"h Utility Account No.�y� <br /> BillingAddres - � j�A�y PermitFee 3� <br /> City,State, Zi 9 Connection Charge(s) � �`��j <br /> D� <br /> Owner (Mortgagor Total Fee�— <br /> Billing Name <br /> Connection By _ __ <br /> Signed '= ' <br /> Address Customer <br /> Phone �3� — �/ �� <br /> Sewer District � <br /> DESCRIPTION: � �7 /� <br /> Lot Block_/�— Monthly Sewer Service Y <br /> Plat Q�' � <br /> Unplatted Description Monthly Sewer Constr. 6 <br /> Y � <br /> Trunk �� _� <br /> Type Permit: ^ p�J�% i <br /> Lateral � 1`✓ •�s <br /> Remarks: qbutting L t Line <br /> � E vy �� ft. <br /> Approved By ��_.//� <br /> Cit Eng�eer <br /> Issued By�C�7:-r-�— <br /> , <br /> Inspection By ` "" <br /> Datelnspected —�� <br /> SEE SKETCH ATTACHED N0. Z331O <br /> INSPECTION <br />