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� <br /> 1� � <br /> � � CHART N0..1' �'''O — '' %- :i ' <br /> � everett � <br /> �03'�'"�-� . . i <br /> E e �. �� <br /> City of Everett � <br /> � : <br /> Engineering & Community Services <br /> Sewer Application and Permit �. <br /> � � - <br /> f N0. `i ' qnrj DATE 7/�/ ��� <br /> ` 6_ .L l l. <br /> Service Address �90 � - ?— ���``� Utility Account No. _ <br /> R U , ,� . . , °._� <br /> Billing Address 3v I ���T �!�- ` � � Permit Fee 30 <br /> City, State, Zip ""�' ��"' ' ' ���'%•�- '��-� J-3 Connection Chargels) <br /> / e� <br /> � Owner (Mortgagor)� � % � � ^- ( _ �' �%%'-=�'��T'otal Fee 30 —� <br /> l <br /> . . <br /> Bil'ingName �� --�, �_�-� ." � ' -.i , I <br /> ;�.�. . .. .P.� ,/ , �._ �- _. - ..y:- J �; 7 i, . ,, <br /> Connection By = - �-� <br /> � <br /> Address Signed � � .:Y� ' '• y'�'�4 S <br /> Customer ' � <br /> Phone '�'�/- y/�/ <br /> DESCRIPTION: Sewer District <br /> Lot /3 — / ;z_ Block G � 5' �- � <br /> Plat �`..< : �— Monthly Sewer Service '"? <br /> Unplat ed Description Monthly Sewer Constr. <br /> Type Permit: 't/a .. ; ' ,. . /'�' J Trunk , _ <br /> , . , <br /> Lateral � <br /> Remarks: <br /> Abutting Lot �ine , <br /> � N, S, E, W Na l'TH F^' D ft. <br /> � <br /> ( <br /> i <br /> I • <br /> � �._ <br /> i APProved By'� �f- , ,.� ,. <br /> Ciry Engineer ��� <br /> 1 <br /> � IssuedBy '-�. -,� � . . �„ __ <br /> � <br /> � Inspection By �j ,� � <br /> I /> <br /> f Date Inspected��L�7 <br /> I e - <br /> � SEE SKETCH ATTAC N0. <br /> � �; � 31'i_i;I IOf�: <br />