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CHART NO. Z / 9-Z �1—S <br /> everett <br /> e �s�� <br /> City of Everett �J �(p�J <br /> Sewer Applicction and Permit �� <br /> N0. ?JSOH DATE ��� <br /> 1620 Heritt 1►wnw <br /> Service Address Utility Account No. <br /> Billing Address Permit Fee �° <br /> City,State, Zip Cunnection Charye�s) <br /> nona <br /> Owner (Mortgagor) Total Fee <br /> Billing Name <br /> Connection By Citr of Lwr�tt <br /> Don YSllar <br /> Address Signed <br /> cu:tomer <br /> Phone <br /> DESCRIPTION: Sewer District <br /> Lot Block <br /> Plat Monthly Sewer Service_ <br /> Unplatted Description Monthly Sewer Constr. <br /> Trunk <br /> Type Permit: ti�v Oonaectiod — <br /> Lateral <br /> Remarks: <br /> Abutiing Lot Line <br /> N, S; E, W ft. <br /> tt. Warren <br /> auu�o�ed sv <br /> j ' � �� Citv Enginccr <br /> � ' � /,� �� � �� . „ � ,,i • E. P.ond <br /> j.._ ' �. i sued sv <br /> / ,� . " � „ � � :/ — <br /> ,�. ��, � � <br /> � y �.. • A/ ,./ i// /7� i� . l`: <br /> i 4; �� Inspection By <=� ,'�� : ; i,� •'i <br /> Date Inspected ' "" </ — ' %:' <br /> SE[ SKETCH ATTACHED No. 23508 <br /> INSPECTION <br />