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kverett <br />� <br />City of Everett <br />Engineering & Community Services <br />Sewer Applicat�on and Permit <br />NO. � � �i'J E? DATE 'I/ 1 /1 � <br />CHART NO��,a= 2A'`+� _ <br />o'���+� � <br />Service Address �L-�4 �.--C���x=- �-�CX�l- K-r�Utility Account No. <br />BillingAddress�.�' �-% �'S � Z'� % _ PernitFee <br />City, State, Zipr'�� ��'��� �-c:: +�� �-� � Connection Charge(s) <br />Owner (Mortgagor) ��/'�U� �> 1�. t-:..l(�' �.�,:-�-.�'CC,�� Total Fee t.__ `'� <br />Billing Name i��" � t. <br />� �--_ <br />Connection By "�`� `-� F' t VQ��� <br />Address Signed �"�""� ��� � � !`<<-ktl���� -�� <br />c�:co�,e. - <br />DESCRIPTION: Sewer District_ <br />Lot -�'�� Block <br />Plat ;.= �-� �--�--� `- �<- i: �=t� Monthly Sewer Serv�ce <br />� ��. <br />Unplatted Description Monthly Sewer Constr. <br />--`-`� t.Rr -- �� . ��� �c'�:Y_T ��L � ' , L � i <br />r...,,, n.......:.. . � . 4 Trunk .. . - <br />SEE SKETCH ATTACHED <br />� •y� I"�;:.PCr �f�� <br />y. � � <br />�.��-�� ���. ��. .,�N�'!R'L. <br />-� Y . <br />Lateral ' <br />Abutting Lot Line <br />N, S, E, W <br />Approved Byl__ . y .t.�,.� :t._:� ,._ l� <br />Ciry Engineer <br />Issued By �-- ` r`�-�; .r�i:-;,�% — <br />I nspection By i � � �'�Q-/�-� <br />Date Inspected `��i � - 7 7 <br />N0. �'` <br />1 <br />,(����'�u�iyy�p� .RF' -. v�vS1e � � � y: <br />__`_ ..5,^_Sl_ii:a54°.'��1.._.�L• if�-_ITh��.4%'Ji.if�.i"� ��'i`.. <br />