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�. everett CHART N0.��2�� <br /> S� <br /> I Pos7�` o � <br /> � e �: <br /> ( / ��/O�� 7 � , <br /> City of Everett Q � ,/ , <br /> �.....,s� <br /> Engineering & Community Services <br /> Sewer Application and Permit <br /> I NO. ;� � QS � DATE f/- /!- if <br /> Service Address - ';L,LI --^-�z" - Utility Account No. �_ -•�( � �� s n <br /> Billing Address �: ro ';% !�,c �� i' � a E Permit Fee y �� �� • <br /> / v <br /> City, State, Zip_,����:l.(-... . .. . ,/�%�� - 'lF���Connection Chargels) �, � <br /> Owner (Mortgagor) ��`-•-- , i '" _ Total Fee 3 '� - � ' <br /> Billing Name ' ( �� . � � �_� <br /> Connection By �'!.� c� <br /> Address_�L�J % ;i!� S- � S /-� Signed <br /> Cusiomer <br /> Phone 5 ��S,'- —:'/C <br /> .., �- <br /> UESCRIPTION: SewerDistrict '��' `—"'"-�� � <br /> Lot /.;� Block 7 y � <br /> Plat �� �r''%.- �/� -.. ,- Monthly Sewer Service <br /> Unplatted Descri�on Monthly Sewer Constr. <br /> Trunk <br /> /' /J <br /> Type Permit: ��j,. -- L` ir - <br /> �t F, � . V <br /> Lateral <br /> � Remarks: <br /> ` Abutting Lot Line <br /> � N, S, E, W ft. <br /> 1/ <br /> /aPProved By` .-- �1 . <br /> CiryEngincer ,.� <br /> .� <br /> Issued By � ` _ - (..1 <br /> Inspection B}��"`� <br /> 0 <br /> Date I nspected ��� �7 <br /> SEE SKETCH ATTACHED Np, ��` "� � �� ;i <br /> IiJSPECI'ION <br /> I ',J <br /> I . ��� ...__�,.,,. �.. ...._ w_ ``__ <br />