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ICHART NO. !� �S �Z5—S <br /> evereri , <br /> � ' Vs� E� ' <br /> /-Z/-�o � <br /> City of Everett � <br /> �� <br /> Sewer Ap�plication and �ermit <br /> No. 22930 DATE � � � _ I <br /> � �,, � i <br /> Service Address ���� -� �7� Utility Account No. <br /> —�--��f' . �>�' I <br /> Billing Address - ��7-p�Q (�✓{� ' � Permit Fee �/1 <br /> � ,� � � <br /> City, State, Zip �-f`'.�1���� 12�, .�2v, Conner,tien Chargels) ' <br /> � - � �� ��� I <br /> Owner (Mortgagor) �� E Total Fee � <br /> i <br /> Billing Name � .�� <br /> Connection By — ' <br /> � <br /> Address Signed _ � <br /> CuS�omer I <br /> Phone � <br /> i <br /> DESCRIPTION: Sewer District — <br /> Lot? ' ')� .s!_�'�B�lo/ck � <br /> Plat •2 --�� /J+'� ��(�.__ MonthlySewerService <br /> �� i <br /> Unplatted Description __ Monthly Sewer Constr. <br /> i <br /> Trun4 <br /> Type Permit: <br /> Lateral <br /> ,�GL' ��'7i�'tQ. '� I <br /> R e a s: � {�V� <br /> Abutting Lot Line � <br /> N, $, E, W— ft. �i <br /> I <br /> � <br /> I <br /> Approved By — ' <br /> City Engmcer <br /> ISSU@d BY I <br /> — � �� �� <br /> � J � <br /> ' InspectionBy // � ��• 'f`. • r <br /> � <br /> I <br /> � Date I nspected <br /> I SEE SKETCH AT'fACHEll No. 22930 <br /> ' INSPECTION <br />