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J <br /> �; �CHART NO.� <br /> everett �� <br /> �'��) �� � �-�-� <br /> e � . � � _ ? _ � g � : <br /> /� 6 �} /�� - ; �. <br /> ' City of Everett l� � ` <br /> ...,, <br /> Engineering & Community Services � � <br /> Sewer Appl�cation and Permit ; � <br /> � <br /> NO. :_' ,' l� .`� .3 DATE ��`/�J/7 <br /> Service Address ^ � �y �� . _,.- , -� Utility Account No.- � — -2�/ - .371- 6 �J � <br /> � � � <br /> Billing Address ��' a'/.� f: � �+.:- ��� Permit Fee ✓ 0 <br /> City, State, Zip=� ivr %,�/,JOf� .�� �� i <br /> Connection Charge(s) /U <br /> i <br /> J � <br /> Owner (Mortgagor) -�-�-v Total Fee 3U �— ' <br /> � Billing Name - _ - C <br /> i <br /> Connection By ; <br /> _- / i. <br /> Address :� t � i <br /> Signed. •� z ;� ��f !,f <br /> � ; � . Cu:;amer �, <br /> Phone -� j� y� 7�'1 <br /> ! <br /> DESCRIPTI Sewer District -�C s�� _-� � � <br /> Lot �� Bloc T • k <br /> Plat � •+T ' � ° � !�-f� - � Monthly Sewer Service �• � � � <br /> Unplatted Description Montlily Sewer Constr. � <br /> j � <br /> Type Permit: /�_ - - �__�-., , . _� Trunk �� � � <br /> Lateral � <br /> I <br /> Remarks: <br /> � Abutting Lot Line I <br /> N, S, E, W ft. I <br /> 4 <br /> I "" � '� ' � � <br /> ' APProved By�Y i��--'�-y:_. , , _ - <br /> — City Enpineer i ( <br /> � <br /> ` . � �� � <br /> Issued 8y �^ • i-,• � <br /> � <br /> Inspection By """��� <br /> Date Inspected_ �/��� <br /> e , ,i <br /> SEE SKETCH ATTACHED N0. � ,i I <br /> ! IDlSPLCI I! �I ' <br /> � <br /> I <br /> +•_ <br />