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CHART N0. '� �� �`� �S <br /> everett <br /> � <br /> City of Everett ��J i�� � - 3i � <br /> Sewer Application and Permit � <br /> NO. G�6�C) DATE Jnnts �n. 19f�0 <br /> ServicF AJdre>s 1102 TTo✓t Utility Account No. I <br /> i <br /> Billing Address Permit Fee 27one <br /> City, State, Zip Connection Charge�s)_ I7one <br /> Owner (Mortgagor) Total Fee_ :Iene _. <br /> Billing Name Nane I <br /> Connection By Citv of EVerett _ <br /> Address Signed �nn t?iller <br /> Customcr <br /> Phone <br /> DESCRIPTION: Sewer District <br /> Lot Bio:k - Monthly Sewer Service <br /> Plat <br /> Unplatted Description Monthly Sewer Constr. <br /> Trunk <br /> Type Permit: RAi?q,. <br /> Laterai <br /> Remarks: <br /> -- Abutting Lot Line <br /> N, S, E, W ft. <br /> _�,�1',�/,� �,�,,.✓ 4" 5 � P • _ m� <br /> ---�I /l,�nr�'J <br /> �5 . <br /> � i S_, r � `'r � APProved By c�•_� +' z <br /> —L / �� 'City Enginccr <br /> — Issued By_ <br /> ---� — S/ %��,��r .< „�;i <br /> Inspecr;,�r. 8y 1 f -- <br /> Date Inspected � a � �� - <br /> SEE SKETCH ATTACHED No. 23636 <br /> IN�PECTIUN <br />