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;,,,� ��-- �..� i <br /> �� � f CHART M0. � � � <br /> � <br /> everett � ///���,�;�rP'�)j� = ��/)/� � <br /> '.'•i L,. �� �4� LJ O e � � �i t/ . <br /> e � o �:�. .� , � ., .: � <br /> FU G 3 0 }g78 � � <br /> City of Everett � � <br /> ........_................. ...� ! � <br /> Engineering & Community Services � C�TY �F E�E�RET , <br /> Sewer Application and Perr�`�`eft,� f��''� <br /> N0. � 2 � � i� DATE /-' ��. 7 ! <br /> � a J ' C ir�-, _ -10 + <br /> 'J�`�7 y�,{,-.• . .1 . f �'� - �lf�.-. Utility Account No. 3— ' � <br /> Service Address_—� y�� <br /> ? v <br /> Billing Address ��� '� l " �� I �Permit Fee � � <br /> ,,� . <br /> l� '�,'� � ." � ✓ ; Connection Charge(s) � f� <br /> City, State, Zi� '_ � , � f <br /> �y 1 <br /> Owner (Mortgagor) -�- � ��- • Total Fee �4 ' <br /> Billing Name � �-'' ` <br /> Connection By '� " ` `"""`� � � � ���� <br /> Signed �� ��*'' <br /> /{C�(��0S5 ' Customer <br /> ' '.� : 7� (j, � ;l d <br /> Phone -' � � <br /> Sewer District '`` - � ' <br /> DESCRIPTION: I - <br /> Lot Block Monthly Sewer Servi � � ' � � � <br /> Plat — � <br /> Unplatted Description ' �v ��`� ' ' '% ��� Monthly Sewer Constr.• � <br /> j( �'� -` 4 .?/. .. .� �i= . . �� � <br /> �. � Trunk� <br /> Type Permit: •� � <br /> Lateral � <br /> Remarks: Abutting Lot <br /> N, S, ft. <br /> , <br /> . M <br /> Approved By ' �'� � <br /> City Engincei <br /> Issued By <br /> r • ' ( <br /> � � <br /> � Inspection � � � <br /> ' �� " �--- <br /> Date Insp <br /> —__-- , <br /> � • NO. � <br /> SEE SKETCH ATTACHED � <br /> INtiPECT!ON <br />