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CHART NO. Y � °L� —S <br /> e�e�eK <br /> e ��� �� _2,_ _: <br /> 8 e� <br /> City of Everott <br /> Sewer A lication and Permit � <br /> PP <br /> N0. 23289 DATE ��M <br /> Service Address=�1! !!� st�t Utility Account No. <br /> Billing Address <br /> �71V Oakt� Permit Fee � _•� <br /> City,State, Zip �'�'t� �• ��1 Connection Charge�s) <br /> � 2.50 <br /> Owner (��T)r'J�il Total Fee <br /> Billing Name �� <br /> Connection By s� � <br /> Address Signed G u:c �r C � <br /> Phone <br /> 252-9228 <br /> DESCRIPTION: Sewer District <br /> 655 <br /> Lot 11 Block Monthly Sewer Service <br /> Plat �11v�1U �ad <br /> Unplatted Description Monthly Sewer Constr. <br /> Trunk <br /> Type Permit: cap—o!! <br /> � <br /> Lateral <br /> i ' <br /> Remarks: ��U r .� �� '� �- ��� 1� '�� '� ' ` � Abutting Lot Line <br /> � �-f"t f �_ N, S, E, W ft. <br /> � <br /> n 1/, <br /> �--.• -• <br /> li. fl�!!�p <br /> Approved By <br /> � �� �� �� Ciry Enpinen <br /> $. BOl1d <br /> / Issued By <br /> ���� IAC�nlE FOiZ �U�' L w . <br /> Of F /N P. �+-�nr <br /> 8 0 <br /> Inspection By <br /> ' Datelnspected <br /> SEE SKETCH ATTACHED N�� 23289 <br /> INSPECTION <br />