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� <br /> everett ��-:`. -� ��i- :;--;�_+ CHART,�NO.� r ! ? _ ��' Y ..� <br /> . I <br /> I ' �`Q��^(ll I <br /> � � G'J� <br /> � '� �?�����`i � <br /> I City of Everett <br /> . . . � � <br /> Sewer Application and Perrn`� I \1 <br /> f ��J`I <br /> f � <br /> Ili - <br /> No. 23250 DATE `) <br /> I <br /> Sirvice Address ( � Utility Account No. <br /> Billing Address ' Permit Fee � <br /> City, State, Zip Connection Charge(s) ' <br /> '- il <br /> Owner (Mortgagor) -% Total Fee <br /> � <br /> Billing Name ' <br /> Connection By _ i <br /> Address � - . Signed - <br /> Cuitomer <br /> I <br /> Phone ' � � <br /> � <br /> i <br /> DESCR�PTION: Sewer District <br /> Lot � Block � <br /> Plat - = Monthly Sewer Service <br /> � Unplatted Desr.ription _Monthly Se�ver Constr. � <br /> Trunk �' <br /> Type Permit: <br /> Lateral I <br /> Remarks: I ` <br /> Abutting Lot Line � <br /> r << N, S. E, 'N ft. '� <br /> � (� K -ro �,J��2, � � <br /> .4pproved By i <br /> City Enginecr <br /> ISSUCG BY -�_ li <br /> � - --- � ' <br /> /,� i <br /> I — Inspection By `-f����� ✓ `i`� I <br /> � <br /> _ Datelnspected � �-� / ' <br /> i <br /> SEE SKETCH ATTACHED N0. (3��0 i <br /> i <br /> Ili.i.-� r i . i� �, I <br /> i <br /> �" <br />