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� <br />everett <br />e <br />City of Everett <br />Engineering & Community Services <br />Sew�r Applica <br />NO. j .1 ;; ;�, J <br />tion and Permit <br />DkTE �`� �i � <br />r <br />Service Addressl�"-'�� �J �i� ,�, �,r,;,� � , <br />r <br />� <br />Billing Address L'�<- > G. ryG >„� r � <br />City, State, Zi � i'� - •:✓ , <br />P � `%`;ZJC;., <br />Owner (Mortgagor) , � ' =t. c' �. i �; . . �,, / <br />Billing Name_ <br />Connection ev i �.: <br />�'l CHART NO.G '—`�-2-�— S <br />I :�� � i G� � <br />Utility Account No. <br />Permit <br />Connection Charge(s) <br />Total Fee <br />5 - �� <br />Signed <br />Cu;romer <br />DESCRIPTION: <br />Sewer District <br />Lot_�_ glock <br />Plat �%' z �< < � � < ; ° u <br />/ % I � �(� N. �Ci :� . Monthly Sewer Service <br />Unplatted Description <br />Monthly Sewer Constr. <br />SEE SKETCH ATTACHED <br />:..--' y o *�.�.5:� - . '-- ,M � ,s.-. <br />. Y>. �}1y t. 4..� ye . � xy., . J. A�� '' <br />t <br />Abutting Lot Line <br />N, S, E, W_ <br />�� <br />4PProved By c.�<<� - � ��i ,,, <br />Ciry Engmeer <br />ssued By �l :� I c:c.-<.�./vZ <br />�spection <br />ate Inspected <br />NO � ' <br />^t <br />INSFECTIOfv ' ' ` `"� <br />�'�._.e--o yI - <br />_ . , �r.a �,' <br />.�. ' . _. _�-:.: <br />