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I .2q '� ci -� � i <br /> CHART NO. � <br /> everett <br /> e - . <br /> � , <br /> City of Everett ' � �� <br /> � ' <br /> l <br /> Sewer Appiication and Permit <br /> N0. 24642 DATE ' - -` -� " �ec: _ <br /> . Utility Account No. — <br /> Service Address <br /> Permit Fee <br /> Billing Address <br /> Connection Charge(s) <br /> City,State, Zip <br /> Total Fee <br /> Owner (Mortgagor) <br /> Billing Name <br /> Connection BY <br /> Signed Customer <br /> Address <br /> Phone <br /> $ewer District <br /> DESCRIPTION: <br /> Lot ���--- Block �14— Monthly Sewer Service ----- <br /> Plat Monthly Sewer Constr. <br /> Unplatted Description <br /> Trunk <br /> Type Permit: Ca Of£ Lateral <br /> Remarks: Abutting Lot Line ft. <br /> N, S, E, W <br /> P � I <br /> � <br /> Approved BY <br /> ity ngineer <br /> c% 3�-� <br /> �— • <br /> � � Issued By I <br /> Inspection 8Y I <br /> I <br /> Datelnspected i <br /> — -- No. 24642 <br /> SEE SKETCH ATTACHED I <br /> �I <br /> INSPECI'ION <br />