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—i <br /> CHART NO. `- '% � <br /> .J � <br /> evereri o a- � <br /> � w O M <br /> e o � � � <br /> w <br /> o � i <br /> o �. sj --� <br /> City of Everett � � �^ � <br /> �.v � � i <br /> ( 1 �- <br /> Sewer Application and Permit � � <br /> �. <br /> � <br /> 8i�ia3 <br /> rvo. 24602 DATE , <br /> 1218 Grand Utility Account No. <br /> Service Address x�(�gr�� None <br /> Permit Fee <br /> Billing Address <br /> Connection Chargels) <br /> City, State, Zip xxaxaa None <br /> Total Fee <br /> Owner (Mortgagor) <br /> Billing Na�ne � <br /> City of Everett � <br /> Connection By Don Miller � <br /> Signed c�slom�, <br /> Address <br /> Phone <br /> Sewer District <br /> DESCRIPTION: <br /> Lot�-- Block�— Monthly Sewer Service�--�— <br /> Plat pllonthly Sewer Constr. <br /> Unplatted Description <br /> Trunk <br /> Type Permit: xepair Lateral <br /> Remarks: � �� Abutting Lot Line ft. <br /> � N, S, E, W <br /> p ��, <br /> . �� � � <br /> ApprovedBy A• R• Theal � <br /> _�� <br /> Cit�•Engmcer <br /> E. Bond <br /> Issued BY---- <br /> 4'�,-� <br /> (�l�o r —, <br /> Inspection By ""' <br /> Date I nspected C � �' � � '� <br /> No. 24602 <br /> SEE SKETCH ATTACHED � <br /> � cu�1c�,�rr, co��� �osren �� <br />