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everett <br />e ��C���C��, <br />� i, � <br />nrT ^' t4�� <br />City of Everett <br />.._... _ _ . _ _.. <br />Engineering & Community Services��-i i`, <br />Sewer A�pplicatiori and Pe�rmit <br />N0. , _ __ _ DATE L�. �� � �Y <br />CHART NO! •' � �� - � "� � <br />�� s �.�'s� � <br />�Z--r 1.-? �'l <br />Service Address -� '' '� � ='-r Utility Account No. -� ' - �— U %b' -�� - <br />/J "� � -- 'y'i <br />Billing Address - '�� ' ' -� �� '' Permit Fee 70 <br />/ � _ �'i�' <br />City, State, Zi� -�'�� -t:�/ i%��J. ��/Cl%�� Connection Chargels) ��3 <br />� .,� <br />� r' ; � %' ` <br />Owner (Mortgagor� - '� ' -��_'` ' ?� •Total Fee � � <br />.� <br />Billing Nane ' �!--�'-r - '----� � —�-��-.._- <br />J � `���/��� <br />Connection BY = "��� --�-- �; � '' �� � <br />�� r �' �. <br />.._-- � � �.: . <br />Phone �/ '�� ' d '" � / <br />DESCRIPTION: <br />Lot� - � ' `� Block� '� <br />Plat ' � i•. fi <br />Unplatted Description _ <br />SEE SKETCH ATTACHED <br />I�� ,. � y ... s ��,�-, <br />���k�i': .i\� fP fz�"S }t;` ��• �,.F i Ji a"' i <br />� .;�ri'��N.���. <br />. <br />� <br />Sewer District " � ���� � <br />�- <br />�. <br />Monthly Sewer Service -'1-� � <br />Monthly Sewer Constr. <br />Trunk1• `/�� - i=il, .�,''� <br />Lateral �"'� � <br />;f •'t� <br />Abuttirig Lot Line �, <br />N, 5,�, W � �� ft. <br />Approved Ry_ `� ' -. <br />City Engincer <br />e ''` <br />�SSUed BV '' _.i'�.. <br />Inspection ' � e-�lt�L-i' <br />Date Inspected � � a � �� <br />NO. <br />� <br />� <br />