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�- <br /> � ��.,�� � �_ � i <br /> everett - � "' — j <br /> 3 � <br /> e �-: ;_ � <br /> t �� �.:� ► <br /> Gty of Eventt ;_ ' � I <br /> E�rinp i Community S�rvias <br /> Sewer Application and Permit `� <br /> s� <br /> ,. <br /> N0. �I 2 C)O 9 . DATE. �� ' � " %D'� I <br /> I <br /> Swvice Address_ �GD F�I ��,t-- - /, � <br /> Utility Account No. � <br /> a a_ � � ,_�. ��_ � <br /> BillinyAddrou� . < -�� Permit Fee�� <br /> , / , !�__ � <br /> City,SLte, Zip^ L,��-_r.—.> �-1 : rllv Connection Charge(s) <br /> I - iQ , �-. - <br /> ,. , <br /> OwnK (Mortpaqor) Total Fee �" � <br /> � BlUfrp Name <br /> i <br /> Connection By --!G!�, ,- ` <br /> � naa�. s�9�d-�..:.�'4_.�i '�`!�L <br /> PI►o,,, J�r _ �/r � / � ��.�o�,.. - <br /> DESCRIPTION• Sewer District <br /> . ,' — <br /> < �.a .� a�ock_ 3 7 �L <br /> 1' R p�n ti F . �� n' �� f �--� , Monthly Sewer Service � <br /> ; Unpl�tted Deittiption Monthty Sewer Constr. � <br /> � <br /> E <br /> � — Trunk � <br /> i� 7yp� Permit: �rn - ./ — <br /> � <br />';f � Lateral ' <br /> ; � <br />; Ram�rks: " <br /> ALutting Lot Line � <br /> N, S, E, W ft. <br /> � <br /> I F <br />� r �.-i�' � � <br /> � : Approved By�� ' �/�- ->: <br /> city eoyi�ex �/, <br /> � � t � <br /> V ( � / <br />�, { tss�ed ev r'� _.:..-, f <br /> I� – <br /> _ Inspection By_ _ <br /> Datelnspected <br /> SEE SKETCH ATTACHED N0. �2 C7 L� 9 <br /> INSPECTION <br />� � <br /> f <br /> I <br /> I <br />