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, ,- <br /> i CHART NO.���.�-� 2�� <br /> everetl � <br /> � � � <br /> I �., <br /> i City of Everett . ' <br /> I Engineering & Community Services <br /> ; Se�nrer A�aplication and Permit <br /> , <br /> � <br /> , <br /> � N0. F� I_ Ei f�� t,� DATE ��f i'%'' <br /> I - -� _ <br /> Service AddressJ --r �� ' i '� -� Utility Account No. <br /> i �l-, <br /> � Billing Address Permit Fee ��� <br /> i <br /> ! Connection Charge(s) <br /> City, State, Zip <br /> ;;_� <br /> � Owner (iUlortgagor) Total Fee �G� <br /> ' Billing Name ` <br /> � ..-}. � � � <br /> � Connection L•'y �' �� ' �' ' - � ; ty <br /> / _�; , �c,..� <br /> 1. ���✓ti-'u..� <br /> Address "%�r�_^�� �' -��=�' <"� ' Signed <br /> Cusromer <br /> w' : / . ,/ <br /> � Phone % �` � <br /> ' <br /> !' DESCRIPTION: Sewer District_ <br /> � Lof%, ;'�- ,=1 o Blocks—" `�Z— <br /> � {�(f , _, f ���� Monthly Sewer Service <br /> IPlat � <br /> Unplatted Description __ _ Mnnthly SPwvr Constr. <br /> � Trunk <br /> Type Permit: - <br /> f Lateral <br /> � <br /> Remarks: <br /> Abutting Lot Line <br /> N, S, E, W _ ft. <br /> �I <br /> i -' ` <br /> � ApProved By.., . :;.,.1 :. <br /> � City Engineer <br /> I — f . <br /> � IssuedBy,-=-, _- .,. ,� j; <br /> i <br /> �� � 7 <br /> Inspection By .l� �t �'i'�'-� <br /> ,�_ Date Inspected �/g�77 _ <br /> ` � - �: <br /> SEESKETCH ATTACH� NO <br /> i i � �, � � "y <br /> �— , `' 'r` <br /> ''5... �3,.,�•t`� ��.-:r, �� r�� �.. �... ' . . „" �, s ��'_: ,�' _.. ��� ,�"1 <br /> _ .__ _ cikSi u��.-r -. . . <br />