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_ _ ._ _. �. . <br /> ' �.,. <br /> � ' CHART NQ �~" �,,,' �i "''4"Ai '_ '? <br /> everett � .; <br /> 1" L� � ��`_�� n' <br /> � <br /> e -. :� � <br /> .. � <br /> . <br /> � Gity of Everett , <br /> Engineering & Community Services <br /> Sewer Application and Permit � <br /> NO. `�� �� L <i DATE � ' % <br /> Service Address ><-• ;'�% i :- Utility Account No. <br /> Billing Address r r% ' Permit Fee ' 1 ; <br /> City, State, Zip `� ✓,';r' - ' . � : i�, .-' i� �.., / Connection Charge(s) <br /> Owner (Mortgagor) ✓ �'. � � -�' Total Fee �. <br /> Billing Name '• � i <br /> Connection By �- • � � - <br /> Address Signed ���- : ' <br /> •� ,�--,�. <br /> Cus�omer <br /> Phone <br /> DESCRIPTION: Sewer District <br /> Lot Block �� <br /> Plat >�%% :_,_ ,f • � : ,, , Monthly Sewer Service <br /> Unplatted Gescription = � � Monthly Sewer Constr. <br /> Type Permit: Trunk <br /> _. ` ,-� . .- f . . �' Lateral <br /> Remarks: <br /> Abutting Lot Line <br /> N, S, E, W ft. <br /> } <br /> . <br /> .l � <br /> � � ' APProved By ., j;F,l. <br /> City Engineer � <br /> � � <br /> Issued By_�.•;"". <br /> Inspection By �� -/ � �-� � <br /> o Date I nspected� — / $ - 7 -7 <br /> �—. <br /> SEE SKETCH ATTACHED NO. ; �. :� <br /> INSPCCTIOfI <br /> 'ti, <br /> .. .�.. . _. . .�,., '_ . ,;,d1 <br />