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CHART N0. <br /> i <br /> everett � ,(,z,� . <br /> 0� ;� <br /> � � . / �� � <br /> .,�� , <br /> , ��., IV� <br /> City of Everett ' 1 � • , <br /> �::�� , ; �, <br /> Sewer Application and Permit `�`°' � ` <br /> No. 23976 DATE a/3o/ei _ I <br /> 3110 Lombard Utility Account No. <br /> Service Address <br /> 1018 ltorth 4IIth Z'S� I <br /> Billing Address <br /> Permit Fee <br /> Seattle, 4�a. 98103 Connection Charge(s) i <br /> City, State, Zip Z.50 <br /> Owner (Mortgagor) Rici�ar3 Diana Total Fee_ � <br /> Billing Name Sa�e II <br /> Connection BY I <br /> � <br /> Address Signed Customer �, <br /> ; <br /> Phone �' � <br /> DESCRIPTION: Sewer District I <br /> Lot 21 _ Block 74Q MonthlySewerService �I <br /> Plat Everett i and Co'a lst <br /> Unplatted Description Monthly Sewer Constr. <br /> Trunk <br /> Type Permit: cup-off I� <br /> -- Lateral <br /> i <br /> � <br /> Remarks: Abutting Lot Line i <br /> N S E W _ ft. <br /> I � <br /> I - - i <br /> � — - F. R. Theal � <br /> � Approved By � <br /> I, �� 1 � — �� n p �J Ciry Engincer I <br /> i � 1.�Q �L <br /> ' - J � E. L�ond �I <br /> � Issued By <br /> ' I� <br /> � _J <br /> Insp_ction BY I <br /> � <br /> �Date Inspecte�l j <br /> SEE SfCETCH ATTACHED <br /> No. 23976 <br /> � Ih1SPkC1lON ���,1 <br /> � <br />