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i evereri <br />� � <br />� <br />� <br />� <br />i City of Everett <br />� Engineeriny & Commur.ity Services <br />� Sewer Application and Permifi <br />NO. �-:-''. =- DATE �- �i �:' _ <br />ServiceAddress � �� f��' ��•''a''�U + �a � <br />BillingAddress �J' ='r �' � <br />, 1;f �. <br />•'% .,. �-..lil.'. .'l•v. '%F^ �i <br />City, State, Zip_ <br />Owner (Mortgagor) � ' � - �• •—� ' ` / <br />� <br />Connection <br />Phone 3 ' - // � ' <br />DESCRIPTION: <br />Lot � <br />Plat — <br />Unplatted Descriptio <br />Block � <br />,�i- r� ,'� uj .J� . .,- � ( <br />CHART NO.J1_1—'��� <br />��%% <br />,�'�G'�-��tv . <br />� -�� � <br />�, <br />',_,,,; <br />Y.. <br />Utility Account No. -" J� '"' � F � U <br />�i <br />Permit Fee_ <br />�, <br />Connection Charge�s) ���" <br />T , ,-� �i <br />S <br />Sewer District `� �lL <br />Monthly Sewer Service <br />.. . S�� <br />Monthly Sewer Constr. <br />SEE SKETCH ATTACHED <br />If�1SPLCTIOf ; <br />. � . .. �^" . . .. .h,� <br />Abutting Lot Line <br />N, S, E, W. <br />_. 1 : <br />Appro��ed By� . C% <br />City Enginecr <br />Y <br />Issued By � <br />Inspection By , � <br />v' <br />Date Inspected �— 2 6 - 7� _ <br />NO. � _ �� _ .i <br />, `z.r_, ._ _ __ <br />