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� - <br /> '��;:r+�:' CHART NO.Z�'�3� ' �`r ' S 3 <br /> everett ' � ' � <br /> �� ; r�,,- � � <br /> � .. �A.�. : � �,� 1 . <br /> � - 3 '' � <br /> i <br /> City of Everett ��j/// � <br /> Engineering & Community Services /,�✓�/ \• .�� <br /> � <br /> Sewer Application and Permit i <br /> / �/ ; <br /> NO. � Z 3 rj �. DATE _7!�// �,r � <br /> Service Address ���� = � = =-u' Utility Acwun: No. � <br /> Billiny Address � Permit Fee --�-� .- - __.�,_— ; <br /> City, State, Zip Connection Charge�s) --'—'`��� � <br /> Owner (Mortgagor) Total Fee -'} - — <br /> Billing Name_ <br /> b " >' ' <br /> Connection By�.<': �-r � �/! �-�_ <br /> � �y /i' i <br /> i <br /> Address � Signed_ r ?��! /� �-�-,�: � 4: ,-,'� � <br /> Customer I <br /> Phone { <br /> � 1 <br /> DESCRIPTION: Sewer District � <br /> Lot Block <br /> Plat Monthly Sewer Service i <br /> Unplatted Description Monthly Sewer Constr. � <br /> 1 <br /> Type Permit: � ,-y�,�__•.� ✓ Trunk � <br /> � Lateral � <br /> I <br /> Remarks: „4,>f. n c_t/ .$. J`. c c ���-- � � ��� i <br /> •� , butting �ot Line ' <br /> cr i�- S. �? tc� , � � .�c `` <�c / ' N, S, E, W ft. , <br /> .!/. .� I . -/ _-r•. 2 Cr��. ,(� ,,:'� <br /> � <br /> v ; <br /> �r�-�� i <br /> Approved By /`/ =�� •- - i <br /> City Engineer � � <br /> I <br /> �- � �'�� / ��, i <br /> Issued By�. •��-->�-a ' <br /> 1 <br /> i <br /> { <br /> i <br /> Inspection By �--�-�� ' <br /> ' Datelnspected ,y — � �1 - 7 � , <br /> ,; :, .:� r' ': � <br /> SEE SKETCH ATTACHED N0. <br /> _ , _ � <br /> �—.-.-,..,s�xcs�r?��S"' .�--�-- s--^�t;;y,M„r-. I�dSPECTION -,_, � <br /> ., , , i i <br />