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J <br /> .. �• Vl�nll l 1\V. <br /> everett ' { <br /> i <br /> e �� _ . <br /> A. <br /> .� <br /> City of Everett : �-` � <br /> � � <br /> Engineering & Community Services <br /> Sewer Application and Permit � � <br /> , , <br /> . � � <br /> n,o. 22495 DATE �/�! 7� � <br /> .; � .� ` <br /> Service Address ^' �^ � • =",�-'=J����'T Utility Account No. <br /> � i �/ J V � <br /> Billing Address �� "�� - � �.L"C� �' U��Y Permit Fee- �� ����I <br /> / / l l <br /> �'/ . �.�`' �yr+� U� Connection Char e�s) J <br /> City,State, Zip_' �_- �� �- - g <br /> � 5 <br /> Owner (Mortgagor) // - .- - =� �_ ..��-:'=? ' Total Fee '�' ��_ <br /> �/ , <br /> Billing Name 4��=!'�- ��' ' _ <br /> ,"'� <br /> Connection By - f - �-- � �`. . <br /> � ; -- <br /> Address Signed���� � , Jr� -`-^ � --�---+-�� <br /> %"? Customer <br /> " ` ,�' �� i...---.�.�F,. /� — <br /> Phone - <br /> DESCRIPTION: Sewer District <br /> Lot �� 7 ' � � Block � ` � <br /> Plai �.- -'i� % � � �� - Monthly Sewer Service , <br /> Unplatted Description Monthly Sewer Constr. I <br /> Type Permit: f ` .��-7_ ��-J Trunk � <br /> ;�'��' Lateral � <br /> I Remarks: ' <br /> i <br /> Abutting Lot Line <br /> N, S, E, W ft , <br /> ,�� .. <br /> ApprovedBy�' ' " r <br /> , � City Enqinett' �/ <br /> ` �� <br /> Issued By % - --'�'`-"- <br /> � <br /> Inspection By <br /> Date I nspected <br /> Y <br /> SEE SKETCFI ATTACHED No. 2 2 4 9 5 <br /> INSPECTION <br /> ` <br />