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everetl <br />e <br />City of Everett <br />Engineering & Community $ervices <br />Sewer Application and Permit <br />NO. F�.��j(? DATE �.(-'�'=`'i7 <br />1 <br />Service AddressrZ�3� �-i� �-{ � ��--'�''��� <br />Billing Address c'�-'''�'�' �� <br />City, State, Zip G--- V t'-t�- -L� 1- `-_J �7C%-� � <br />Owner (Mortgagor)'�'� �+-� �-- C--�-���- <br />Billing Name <br />c_::=�+�r",, r. <br />Connection By �'�`T L*' '�-• v�'` u7 <br />Phone <br />DESCRIPTION: <br />Lot --'t - �'-��--1 Block�f U <br />Plat =='T t�1lC��C:�.��`�, <br />Unplatted Description <br />CHART NO.���2Q-'� <br />Pm s ��o .¢ <br />Utility Account No. — <br />Permit Fee � l L ���� <br />Connection Charge(s) <br />Total Fee N�=�� <br />Signed �^-�-�t— �-�C=�>�..:ca1C V.a <br />Custamer <br />�m �T„ , Sewer District <br />�r :- . . .. .: <br />Monthly Sewer Service. <br />bCT ' � <br />Monthly Sewer Constr. <br />„ <br />Trunk <br />Lateral <br />Abutting Lot Line <br />` N� S� E, W— <br />SEE SKETCH ATTACHED <br />i� '<P' ,'.l I <br />a. <br />4 � lr\' �•I( <br />Approved By �. . N-E� �l-� f ti:4 <br />City Engineer <br />IssuedBy � (_.__�\(.�(..�Ji_J..;;.ui <br />Inspection By �`�� �"L'� <br />Datelnspected �G - G/ ` 7 % <br />N0. � <br />f <br />�. �.� yt .;� • � e51 <br />.�.: tiK .eS�:'� ___ - <br />