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CHART N0. V � �Z�i !s <br /> everetl <br /> � � � ` ��d <br /> City ot Everett P���� <br /> Sevorer A lication and Permit � <br /> PP <br /> NO. 2�683 UATE � S � " <br /> � <br /> Service Address -� �' �� �• ������ Utility Account No. <br /> � �j� ` ..5�' <br /> Billing Address��"!a �� Permit Fee <br /> City, State, Zip - ���= ��r t✓ �J Connection Charge(s) <br /> /� / � <br /> Owner (Mortgagor) /7 r��G� ��" �4�C �a' Total Fee �" � `S <br /> Billing Name C-�1 i%U�/ �C�f� � � d • r�� <br /> Connection By_ — <br /> � �j � ��� /,�, . < <br /> r � !�J /`5 f'oAc/.dv/+H Stgned ':_'.-'/�.s+ .. <br /> Address__, ,. —�� JCustomer <br /> Phone -� ��- ����/� � <br /> DESCRIP;fION: ��� SewerDistrict <br /> Lot � Block <br /> �� , .: Monthly Sewer Service <br /> Plat_G��� �- L L !7G� <br /> Unplatted Desr,ripticn_ fVionthly Sewer Constr. <br /> Trunk <br /> Type Permit: <br /> � �, Lateral <br /> � �.u�r�r' C.s�L�� � , <br /> Remarks:Si� !S-,�,.�r��„G�- � 3,= ��// <br /> Abutting Lot :.ine <br /> � .��. �'., >Sc�-�� i.,w� N, S, E, W ft. <br /> � : ..-•-'-- <br /> i>P i7f �'JC3 ' 3' ..��'.o�> > - .�D�� / . <br /> � ' <br /> i.. .'7� 'r ' f"N �c�•.:�� .� /�. �-. <br /> �' ;G.v� c� -� y% _ ' , : <br /> / J J Approved By <br /> .f-' J,..,�/ � �/�e�l� �,�l.f'h .Hi.� l�."�lfi CitVEngineer . <br /> ��,_.' :.�o`y f'7 i„'r ��i ��i' �'�'c1G' I . .� . . . . . <br /> - Issued By <br /> �. � � <br /> — - � <br /> v ,-. , <br /> �"� �'- �. <br /> Inspection By����--�-^--��� <br /> %� <br /> Date I nspected Y -�-�- �� �"� <br /> SEE SKETCH ATTACHED N�• Z�S�3 <br /> (— I;l.;PECTIC�: <br />