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CHART N0. S <br /> everett <br /> e r . ;3 . <br /> � ��� � <br /> City of Everett , ' � <br /> � <br /> Engineering & Community Servicas <br /> � <br /> Sewer Application and Permit - ; <br /> , . , <br /> No. 22537 DATE �' ����� � <br /> � <br /> Service Address_ r"'� � �� �' ' " ' 1-�-r"� Utilit�� Account No. <br /> J/ ��� <br /> Billing Address S�� �� f�"`� -•�" Permit Fee �D � , <br /> �, ,_,/ f' �- <br /> City,State, Zip�� ' '/ -:� • ^���=G� Connection �harge(s) <br /> � ;�% • s� <br /> Owner (Mortgagor) ' '� -✓ • '=���"'� ``�--yv Total Fee �� <br /> i <br /> BillingName _ :'�--z-_Ft— <br /> Connection By :-'-%-- <br /> Address Signed � <br /> cu:tomer <br /> _ i' � <br /> Phone r" .' /-� ,^�( � � <br /> DESCRIPTI.�N: Sewer District _ <br /> Lotrr- `� / � Block l��2— <br /> J <br /> �t ^ ��-r <br /> Plat'�` - '� - � � ��,, . /.�. Monthly Sewer Service _ <br /> . <br /> � <br /> Unpl�tted Description Monthly Sewer Constr. <br /> — Trunk <br /> Type Permit: " <br /> ,.� ' - <br /> Lateral � <br /> Rcmarks: <br /> Abutting Lot Line <br /> N, S, E, W ft. <br /> � <br /> �/. <br /> Apprcvcd "uy � _ . /,,/��•, ,-��-;�-. <br /> City-Engineer �� <br /> r. • �., �' <br /> Issued By �� • --1� <br /> Inspection By-- <br /> ____�Datelnspected <br /> e <br /> SEE SKETCH ATTACHED No. 2 2 5 3 7 <br /> IhISPFCT!0?J � <br />