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, <br /> CHART NO.Z I 3 ` z�j' -� <br /> Ieverett � <br /> � ''J > ': <br /> �� ''�_�C35T�'�-31�° <br /> City of Everett <" � <br /> , � 'r � <br /> _ � <br /> Sewer Application and Permit �= r�~ <br /> _,, <br /> No. 23635 DATE / 1 ' <br /> Service Address �h �' ,��� l����-='T� Utility Account No. <br /> Billing Address � Permit Fee <br /> City, State, Zip_ Connection Charge�s) <br /> O�Nner (Mortgagor) ` Total Fee � <br /> Billing :Vame � <br /> Connection By <br /> � , <br /> Address { Signed <br /> Customer <br /> Phone ' � — ' <br /> �ESCRIPTION: Sewer District <br /> Lot � Block�— Monthly Sewer Service <br /> Plat ' '� <br /> � <br /> Unplatted Description Monthly Sewer Constr. <br /> _ Trunk <br /> Type Permit: _ff <br /> Lateral <br /> Remarks: Abutting Lot Line I <br /> � _ N S, E, W ft. I <br /> � <br /> (' O � <br /> /�_Q � < . <br /> Approved By ' <br /> Ciiy[ngineer I <br /> Issued By -� i <br /> —^�-'] % �f�%�s%�` � <br /> � �— Inspection By�1;,.i��.�i.'°��'L.---���-- � ` <br /> � <br /> � �, <br /> � � Date I nspected__�^� v ' d='=�-- — li <br /> SEE SKETCH E\TTACHED No� 23Ei3'i � <br /> — <br /> INSPECTION I <br />