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C;�ART NO. " <br /> evereri <br /> � ' �Gl��'. <br /> � Ol_ . <br /> City of cverett ' . . <br /> Se�e�° �, �icati�n ��e� Pe�ev�i�� I <br /> �� <br /> NO. �.�QF_�,E! DATE ���-=�� - <br /> Service Address a � �� � ��% , _ Utility Account No. <br /> BiliingAddress�y/��G�- Permit Fee ,� � __ __ <br /> Ci:y, State, 2ip�.+;�.s� C� Cor�.nection Chargels) — <br /> Owner (Mortgagorl - Toc:l f=.�.:_ � _ ---- -- <br /> . / / <br /> Billing Name � � � ��c _ <br /> Connection By__ ___ <br /> Address_ Siqn�d __ <br /> cusion.i <br /> Phorn�---_�J�'� " (� �.�� <br /> DFSCRIPTION: Sewer District <br /> `f/ `. . _ . . __ ._ _—. .._._.._ <br /> Lai . � Block Monthly Sewer Servir.e <br /> Plat�'-�1La,2,,;� � � - - . — <br /> Unplatted Desci iption Monthly Sewer Constr. <br /> Type Permit: o� �� > Trunk___ __ __ _ __ <br /> I Lateral <br /> Remarks' <br /> Abutting Lot Lin�.� <br /> . I ' . `-�. E, Nl- � - � - - � �--- it. <br /> �--� , �S U S �� 0� Iv� li.� -. .�� <br /> FEG�s � . <br /> Ap�roved By <br /> c�n e,.�,� � <br /> - Issued By � ___ <br /> - -- I <br /> / / ,, . 1_ <br /> Inspect�an By ����+� `''� <i �_ -- <br /> _ � �� �< < � <br /> _ _ _ _ Date inspected � _- <br /> tiEE SKETCH P�tACHED No. 230G6 A <br />