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'I CHART N0. �'�y�� �'' <br /> eVefett /�o S %�.' � z� . <br /> � e <br /> � <br /> , <br /> ICity of Everett <br /> I <br /> i Engineering & Community Services <br /> f Sewer Application and Permit <br /> i <br /> � <br /> .� <br /> , , ., .. , �� _. ;�� <br /> , NO. � , I O � DATE � <br /> il <br /> ( Service Address 'J. Z 7 � ��/�U�� Utility Account No. <br /> i - <br /> '� Billing Address ` ���'^ Permit Fee �✓ = F r�' <br /> ' City, State, Zip �=✓=�'=rr�-. ,�> �-+. l.�x' � Connection Charge(s)__ _ <br /> i , <br /> i Owner !Mortgagor) Total Fee N„� r- ��' <br /> I <br /> I Billing Name — <br /> � <br /> i Connection By � � �Y "'" �����"�" 1 <br /> I �� .� <br /> I Address Signed t'"���`� �--x-��t-�-t� <br /> Cuslomer w� ��„r <br /> i Phone <br /> i <br /> I DESCRIPT�ON: Sewer District , <br /> � Lot �� � � Block '� �"'' � <br /> �, Platr�tr�. >. y �.. ��e,'o Cv`s 3�J-> ��do <br /> Monthiy Sewer Service <br /> � Unplatted Description Monthly Sewer Constr. <br /> � Trunk <br /> i Type Permit: <br /> -"'! Lateral <br /> S%"n..�t �. .>-t i � — <br /> � Remarks: <br /> i _ Abutting Lot Line <br /> � . /�W,w.� N, S, E, W ft. <br /> i <br /> i <br /> ! S� . �,J 5-/ �, <br /> , <br /> ! � �� � /V � � � C� lirti � y� Approved By � �9-� ..rr--.; <br /> i Cit En meer <br /> � <br /> i <br /> ; Issued By � �':���"--� <br /> � <br /> I <br /> r � ^ <br /> ' Inspection By �aiw <br /> i <br /> i Date I nspected y—� — '7 7 <br /> � � � . � <br /> i SEE SKETCH ATTACHED N0. ._ _ . �: �- <br /> I(4SP[STIOPi � <br /> ' r: <br /> . � . -+�. `4 . ; 'u"�� . <br /> , ', ., <br /> r.5+::� _:v,,;�.r . '- t1Wyfi:v:. � ':) -� �r:':.-_ .�.x.fer...y. . .o�.iF`t.'.a'�:. <br />