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. .�. r.. .._ . _. �I:'`. Y. <br /> �I } CHART NO.�y/l ' '� <br /> ; everett ,,..,.. ..,, <br /> . . �. r� �:� <br /> � a � : ,; <br /> w • <br /> � City of Everett <br /> Engineering & Community Services <br /> ! Sewer Application and Permit � , <br /> f n,o. 218 0 7 DATE `� � � � ( � � — <br /> Service Address '=�'`��-�t '')�"""'�"'u I`•J��'u Utility Account No. � - `"`F �(� ���U <br /> �:�� <br /> BillingAddress � L�'�,'' ��=' '�'� PermitFee '-'�'• <br /> ., � l.s �' . <br /> City, State, Zip �L-'-��Lut�E. r 11 C�C'�� Connection Charge(s) �- <br /> - �.t. , " ',U. " v <br /> Owner (Mortgagor�r���--����F� Tu �c--U�l-�.< <--�i Total Fee <br /> Billing Name_ `�1�v '� <br /> Connection By ��������J <br /> . r_ � � � <br /> Addre�s�G�� �'�'^-,T �_� � (.�J Signed �c� �ii e�r , �� //i'ir�J�-.r-' <br /> Customer <br /> Phone "� - � I �� <br /> D�SCRIPTION: Sewer District � � �' �� �- �-' ' �—r <br /> Lot � � �� Block � <br /> � � Monthly Sewer Service L ` � � <br /> Plat ( J�� �. c L� , � �c.v <br /> Unplatted Description Monthly Sevoer Constr. <br /> Trunk ( � � <br /> Type Permit: �.J��_t..� �C, u -,t c z• c ,�.= - - <br /> Lateral <br /> Remarks: <br /> Abutting Lot Line <br /> N, S, E, W fL <br /> i <br /> � APProved By � � � c. �=f.J� ti�l � <br /> Ciry Engineer <br /> Issued By.��*? � i� / <br /> Inspection By G 'L ��"�'"�"", <br /> � Date Inspected ��L7� <br /> 0 <br /> ! SKETCH ATTACHE N0. <br /> � �� �� li�lSfi=CTIC�i: <br /> � -- :x ' <br />