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CHART NO.,�TL�� � � <br /> everett _ �Q s ��O <br /> i <br /> � S-- i3 — � Y � <br /> � <br /> City of Everett ' <br /> Engineering & Community Services • � <br /> Sewer Appli�ation and Permit I <br /> DATE �//�'-' � � i <br /> No. �2340 i <br /> , , � <br /> Service Address ``J� ' �•J - - � Utility Account No. <br /> Billing Address �� Permit Fee ' ' `'"-' <br /> � ir, � _------' <br /> City, State, Zip "�`"� ✓� ' �� '� Connection Charge�s) <br /> Owner (Mortgagor) Total Fee "� "'"'- � <br /> Billing Name <br /> e- �- r ` �— <br /> Connection By �--�-'�A ' <br /> , : <br /> v . _ / . <br /> Signed �-.' ",'-/� _--s- y.�-."°'L <br /> AC�dfeSS Customcr <br /> Phone <br /> DESCRIPTION: Sewer District <br /> Lot Block Monthly Sewer Service <br /> Plat _ <br /> Unplatted Descr�ption Monthly Sewer Constr. <br /> Trunk <br /> Type Permit:��,... .,:.,.c.- % � <br /> Lateral � <br /> Remarks: ��, _ ' �, �.�� z <br /> � Abutting Lot Line <br /> cl.t. �. .� c.� ✓ �v-cr N, S, E, W ft. <br /> �-zL c/��,.�- ' — <br /> / � <br /> Approved E1 ��� --. <br /> Ciry Engineer . <br /> ��l <br /> Issued By �`1 ---�"�-" �`, <br /> InspectionBy ��g..�• f �L^-�'Q'�a"-"'� <br /> Datu I nspected � �� ' i �' { <br /> o � <br /> SEE SKETCH ATTACHED N0. � � <br /> IicSPLC1�lOfd � � <br /> . .-,. .. ._ �. _ .. . ... i <br />