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, <br /> - � CHART N0. ��-29�5 — <br /> _. <br /> everett . <br /> � . .. . � —�J � <br /> � O� / ' �" <br /> City of Everott y -�/1�"n-�� � <br /> Enpimerinp � Community Ssrvicss �� <br /> Sewer Application and Permit � <br /> N0. Z�L S Z O DATE ,�d " �' � � <br /> Service Address �0 G � ,/fJ,:�. � Utility Account No. �' <br /> Billinp Address.���a.�—_�l t � '' ' Permit Fee � i <br /> � ' <br /> / ^ � <br /> Ci State Zi �*^'�"�',:,.''�, �` ��^`l� Connection Charge(s) ' ' f <br /> �Y, , P / q <br /> / � 7 � / <br /> Owner (Mortgapor) ��-,, ` (�` '� ��� Total Fee_ — ; <br /> � �a <br /> f. Billiny Name -�•� �-,.��L� � <br /> �:. <br /> �: , <br /> Connection By /�—` � ° <br /> C._ � /� ��� p <br /> � Addhst Signed� �/' _-.}'JZ%i/� <br /> c��o� <br /> { rho� S"6�S'— 3/7� ; <br /> OE&CRIPTION: Sewer Pistrict _� � <br /> �a 81oak,�/' �,rs Monthly Sewer Service �"�« ' <br /> +� ✓1 <br /> PI�L ��s��jGf�c- <br /> UnplKted De�cription Monthly Sewer Constr. , <br /> ,�! Trunk � <br /> � Type Psrmit: � � � � �- -: I.. , , � - <br /> � �_ � Lateral <br /> �t., _ � L ; '�..�, . y.�, <br /> k Remarks: Abutting Lot Line Z <br /> :� % <br /> r � !`. ,.-+/ ft. s <br /> s� � N, S, E, W_,l�i:� <br /> i, — <br /> �: i <br /> � <br /> � �1::. • � <br /> ; APProved B,�' �rcy oo�orer,L <br /> i <br /> � <br /> Issued By �=' ' „�-''"ti.:``r , <br /> � G <br /> � Inspection B <br /> Date Inspected `� <br /> , SEE SKETCH ATTACHED NO. 2� � 1 O <br /> INSPECTION � <br />