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I - CHAR7 NO..•t�' ; <br /> ! :r <br /> everett �05✓�•"^£� � <br /> i <br /> � e , <br /> �' City of Everett <br /> Engineering & Community Services <br /> � Sewer Appiication and Permit <br /> � NO. t, � `, :i i DATE �_ S - %'1 <br /> Service Address ^' S� 3 - � -`:-f Utiliry Account No. %- :-: 6 - '31� • �� <br /> . i <br /> Billing Address�.V� � � ��.�` ��� • Permit Fee -i v <br /> City, State, Zip� �� ' � '�''-`-', '� • Connection Charge�s��D �'¢� <br /> ( ' -, °i <br /> � -� � G"., ; � .�U <br /> Owner (Mortgagor��-_��_„ =�---- '�r '/ `- � J' Total Fee <br /> Billing Name --��`'� ��--c---' <br /> f; <br /> Connection By "---�'=�-�• i=-= <br /> � J <br /> fAddress Signed ✓I e �!/�ic CG /l�'i[.✓i*ir_% — <br /> � customer <br /> Phone ���1 /3� 7 <br /> DESCRIPTION: , � Sewer District ' �' + , � <br /> Lot -' � Block :���-. �•<::a' :,- c� <br /> Monthl Sewer Service <br /> Plat�L./'"_,__�f—,�i c:.r,.� Y -- <br /> � Unplatted Descrip�on Monthly Sewer Constr. <br /> ' Trunk �• �'� <br /> ' TYPe Permit: �'_[".;r� � r - ._-, ., ,- 1� <br /> iLateral —�-�"` <br /> � Remarks: Abutting Lot Line <br /> � N, S, E, W ft. <br /> I — <br /> � , <br /> � APProved B�J ' , '•� : <br /> f CiryEngincer �� <br /> � Issued By �' � -'--�— <br /> I <br /> i <br /> , �7 "� <br /> �� Inspection By /���z'�w���'`�-�— <br /> � Date Inspected l� 77 <br /> I Q —�___ <br /> i SEE SKEl'CH ATTACHED N0. <br /> � � � :Sir� � � �ni�' <br /> ' ,�� �, _ ,_ <br /> � <br />