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1 <br /> � <br /> City of Everett <br /> Sewer Appli�ation and Permit <br /> N0. 2281G DATE �I ��� <br /> ; Service Address - ;L'>' � ' % Utility Account No. _ <br /> i - <br /> IBilling Address -:';l ' .r ; , ' / •� Permit Fee . � <br /> ' City,State, Zip_ '� �i/ . ,,�' '' ' Connection Charge(s) <br /> I Owner (Mortgagor) �! Total Fee - "� <br /> t <br /> Billing Name '`� ✓ � <br /> Connection By ' <br /> ; <br /> Address " � , ' / � � �`� �' Signed � '�'�l� <br /> cu:comer <br /> f one_ � -r' :�- �� <br /> �{fi i <br /> DESCRIPTION: / Sewer District <br /> Lot ( � Block � % � <br /> Plat-_ "% , ._ / .� Monthly Sewer Service <br /> Unplatted Description Monthly Sewer Constr. <br /> Type Permir. �. ,� <br /> Trunk <br /> ;'� Lateral <br /> Remarks: <br /> Abutting lot Line <br /> N, S, G, W ft j <br /> Approved By_ // <br /> Ciry Enpinett <br /> i <br /> ISSUCCI By �__� <br /> Inspection By <br /> Datelnspected <br /> SEE SKETCH ATTACHED NO. ZZ�1Z <br /> --------'.�_f�.� w — <br /> -•-Q�- ssoazc <br /> �_,�_ _ - - ---__ <br /> - — . _ r` <br />