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_ , <br /> � � � '� CHART NO.�..�_ <br /> everen ��� '" � ` C- `6 --�b =Z�J <br /> e _ �y ��9 <br /> City oi Everett � <br /> Sewer Application and Permit <br /> N0. Q3127 OATE _= – '_�l <br /> Service Address �/U // - ' Utility Account No. <br /> BillingAddress---'� !� -- � � � Permit Fee ' ��f � <br /> :���--�- <br /> P <br /> City,State, Zip ,l f � - - �� Connection Charge(s)_ � <br /> , <br /> Owner (Mortgagor) � .�1 �Total Fee . <br /> Billing Name _c� <br /> Connection By – �� _ <br /> Address � Signed - ` <br /> , � - - ciuwmer� <br /> . '�, ;f Phone � <, �/� �,— <br /> 't „�:.� <br /> �:. . s <br /> � <br /> ,';`ti DESCRIPTION: Sewer District <br /> . _, .�si::Ya <br /> :�..� Lot ��- /- Block / % � <br /> * ' � Monthly Sewer Service <br /> Plat "� r <br /> Unplatted Description Monthly Sewer Constr. <br /> Type Permit:�� , - Trunk <br /> Lateral <br /> � Remarks: <br /> Abutting Lot Line <br /> N. S. E. W '/, � % � ft. <br /> O To oJE� <br /> �. <br /> Approved By '�' <br /> ' CitV Enqineer <br /> ISSUC(I B�, � - <br /> Inspection By � <br /> Date Ins�.�ted_ 7 ' � � ' 7� <br /> SEE SKETCH ATTACHED NO. 2312T <br /> INSPECTION <br />