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• CHART N0. n `� v -7 `�SJ <br /> everett - , /�o s c�= Q a q <br /> � , <br /> City of Everett . <br /> Engineering & Community Services <br /> Sewer Application and Permit <br /> , <br /> N0. 217�. �L _ DATE 3��/` '77 • <br /> ' ec. .cG..L. • <br /> Service Address !Y30 l��.A�' �`= Utility Account No. <br /> _ �: <br /> BlllingAddress /'-��`-`�' �" '� PermitFee ^�'� ����� <br /> City,State, Zip (��*'-i1��-�!��� ��y'�� Connection Charge(s) <br /> !rin R •� �s-� Total Fee ^�� �'�% <br /> Owner (Mortgagor)_ \ = <br /> Billing Name_ '1•�'�- <br /> Co�nection By `v � ` /� <br /> 4 `�'=G� 11a`'!`�/�� <br /> Address Signed <br /> cu:romcr <br /> Phone <br /> DESCRIPTION: • Sewer District <br /> ���, y 36s�" - <br /> Lot_1� rE'-�F-C�i ��I� ck Monthly Sewer SerJice . . . <br /> Plat � � <br /> Unplatted Description `.Monthly Sewer Constr. ; <br /> Trunk <br /> Type Permit: .�X� �. ,��- <br /> Lateral <br /> Remarks: � ��l' � , � , � <br /> Abutting Lot Line <br /> �. P � ��lL.t�. � � �— �crrx- 7 N• S, E, W ft. <br /> � • <br /> APProved By . � � • � . <br /> City Enyineer / � <br /> Issued By��-/-����� <br /> Inspection By�� �1-rt'a�� <br /> � � Date Inspected ���- N " 7 `y <br /> � SEE SKETCH ATTACHED NO. �1.7 �. 2 <br /> `,� ..._�.._�-^....-- - -.,.-- �_� INSPECTION �-- _....- -._—.� --,--.-- . -_—_�.� <br />