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3 s-s - �_s` <br /> or ��r� � <br /> '� CHART NO. <br /> everett . � �S r Y�`— ' <br /> �/ �_ / � %� GL ,� ,^_rQ� /'�O cs ��'r� ; <br /> e � J� <br /> , � �^e <br /> V ` � ~r �� <br /> City of Everett <br /> Engineering & Cuinmunity Services �J���� , <br /> I <br /> S��wer �►�plication a�d Per�mit ' <br /> NO. �: ! i' ! 'v DATE - ��.� /=� ' <br /> � , <br /> Service Address �ti ` �� ' Utility Account No � � ` ` - ; <br /> Billing Address � - Permit Fee >�- i <br /> City, State, Zip '-�� ^�+-+�!` �f %�' y Connection Charge�s) _ <br /> i <br /> Owner (Mortgagor) i �,� !' ' Total Fee_ _ " _ � <br /> r � <br /> Billiny Name ` " �' ' <br /> Connection By j <br /> Address_ Signed � �� /� ��( _ � <br /> Customer � <br /> Phone_ _ <br /> DESCRIPTION: Sewer District_- _� <br /> l.ot Block � <br /> Plat Monthly Sewer Service i <br /> , � � <br /> Unplatted Description ' ' Monthly Sewer Constr. � <br /> i <br /> Type Permit: - Trunk i <br /> _ , . i <br /> i , Lateral � � � <br /> Remari<s: � ��' � I <br /> Abutting Lot Line ; <br /> N, S, E, W ft. <br /> � I <br /> t <br /> i <br /> i <br /> ,APProved By 'r� . , � I <br /> __ Ciry Enyincer ' ' � <br /> � <br /> Issued By __ i <br /> i <br /> I <br /> I <br /> Inspection By��.—����- � <br /> Date 1 nspected 7�'/Z -7�' <br /> n <br /> SEE SKETCH ATTACHED NO. �.' '. .` � <br /> T If�a."�rr���(l�i ,� <br /> .'r'3-�' .'e , <br /> c,.Y �' . � �+. �'e YS z� �1 �_ _...A r+ ±Y^ a .�-.,��. �H ��y„x .� . <br /> . . � ��'X.� _ _ .. . ., ,. I _ . ._ °, _ _ . . �L �.��.15..� <br />