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CHART N0. <br /> i everett <br /> I <br />� - - � �D��p � <br /> City of Everett `" ` — � Z <br /> Sewer Application and Permit �- <br /> No. 24303 <br /> DATE �� '����� <br /> Service Address ����� ��''Y� Utility Account No. <br /> ,{n� >� : � <br /> Billing Address /��+ s' Permit Fee <br /> ^��.�Ff �/ � �yf(7G',/ Connection Chargelsl— i <br /> City,State, Zip.��—, ��— " . <br /> , ��y , y �f� Total Fee ��� � <br /> I Owner (Mortgagor)�—� <br /> . <br /> Billing Name <br /> Connection By <br /> Address Signed — <br /> Custamer <br /> Phone — <br /> DESCRIPTION: Sewer District <br /> Lot � � �^'" JBlock /��G Monthly Sewer Service <br /> Plat l .'i.''� ,ij<zr J9( � <br /> Unplatted Description Monthly Sewer Constr. <br /> Trunk <br /> � Type Perm' : <br /> , � l� � i�`.'� Lateral <br /> Remark�• f ���� Abutting Lot Line <br /> N, S, E, W ft. <br /> � <br /> �/ . I� <br /> Approved By /�' ,!J �'� `� <br /> ci�v Eng- .J�� I <br /> V/ //� <br /> Issued By �f��"'k r"�� �� <br /> I <br /> c � <br /> I Inspection By � <br /> Date Inspected ���r-� � � I <br /> SE� SKETCH ATTACHED N�� 24303 I <br /> INSP[CTION I <br /> i <br /> I <br /> i <br /> i, <br /> � � <br />