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■` r <br /> CHART NO..� l3 �� � <br /> everett <br /> �- <br /> � � _ <br /> � (:ity of Everett �'/`� / <br /> I <br /> �! S�wecr i���p�i���tion c�nd P�errnit <br /> � <br /> I N0. �`��o� DATE ����� <br /> Service Address/�"7/ - Utility Account No. <br /> i � - Z,�y �C7. <br /> I Billing Address � ' - Permit Fee �� <br /> � City,State, Zi�ll-���_����� Connection Charge(s) <br /> . <br /> : , (�'r�) <br /> 9wner (Mortgagor); r r ;- �_- ' �:--�.. f'j,=- _ ` Total Fee ��n <br /> Billing Name � L- <br /> Connection Ci}l-��' � f/��.�� <br /> � Address Signed;' `'f� '�- ;�`"` �� <br /> Cusromer <br /> � f1 <br /> �.;, . c- <br /> Ph�ne � —_ _ <br /> I DESCRiPTION: Sewer District� - -- <br /> Lat _ Bbck <br /> Monthly Sewer Service <br /> Plat <br /> � Unplatted Description Monthly Sewer Constr. <br /> � <br /> i ,/ Trunk _ <br /> �'ype Permit: <br /> Lateral <br /> Rcmarks: <br /> AbutLng L.ot Line <br /> N, S, E; W ft. <br /> Approved By^' � _ <br /> aiv e�e��c�� <br /> IMPORTANT! - f <br /> Issued By t__ (. -.;'_.%_,(..; I /f :_�.� -' _ <br /> CALL 1-800-424-5555 48-HOURS <br /> PRIOR TO DIGGING <br /> CALL2596811 FORINSPECTIUN <br /> IInspection By � <br /> Datelnspected��a. _ <br /> SEE SKETCH ATTACHED No. 2548�`� <br /> I �".f <br /> I f.,,f'i.C I I l)i'1 <br />