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- CF!ART NO.'� J I '� ._ �o % <br /> everett <br /> e <br /> City of Everett ' <br /> _ � , <br /> Sewer Application and Permit <br /> No. Z6972 DATE �►�- t7 -8R <br /> $ervice Address 2 Z p 1 '�t�"^� Utility Account No. <br /> Billing Address Permit Fee <br /> City,State, Zip _ Connection Charge(s) <br /> ONmer (Mortgagorl Tc:a� `ee____ <br /> Billing Name <br /> Connection Bys.��'� � �Ue h� t� <br /> Signed <br /> Addf855_ Cus�omer <br /> Phone <br /> DESCRIPTION: Sewer District <br /> Lot Block — Monthly Sewer Service <br /> Plat <br /> Unplatted Description Monthly Sewer Constr. <br /> Trunk <br /> Type Perrtiit: <br /> Lateral <br /> Remarks: � Abutting Lot Line <br /> n l .in �— �i Otf.�'� m�r fr �r.i.oz � .� N S E W ft. <br /> ` ����_. /1.iJf+./- _C.�/1![t�c't/2ce� — <br /> .f.- <br /> 1��„�.l �.,�� , <br /> Approved By -- <br /> Gry Enginecr <br /> IMPORTANT! _��,_�_�,���� �Y <br /> Issued BV <br /> CALL 1-800-024•5555 48•HOURS <br /> PRIOR TO DIGGING <br /> CALL 259�8811 FOR INSPECTION � / z /�2� <br /> ,/ 7�,�,� r � ,� <br /> Inspection By-_�5�� <br /> Date Inspected - <br /> SEE SKETCH ATTACHED N�• � �C� � - <br /> CU.ri�Ci�1Gfi CC;"i <br />