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1 <br /> CHART N0. <br /> everett <br /> e <br /> City of Everett <br /> Sewer Application and Permit <br /> N0. 22815 DATE � � �� <br /> _� . <br /> Service Address '-'� �� " " ' �UtUity Account No. <br /> i.�i— <br /> Billing Address , n � ' ' ��`� Permit Fee ' <br /> City,State, Zip � i � ' Connection Chargels)� <br /> �. �� <br /> Owner (Mortgagor) Total Fee <br /> • �i <br /> Billing Name '-'— <br /> Connection By ' " e—. <br /> ',j / . ''�,� Signed -(—, /'� � <br /> Address c�:co' w� <br /> Phone - � ��� � <br /> DESCRIPTION: Sewer District <br /> r � �� <br /> Lot ��� , ,�� ` Monthly Sewer Service <br /> Plat (1=iL�-�` .r---��:� ,L-( <br /> Unplatted Description Monthly Sewer Constr. , <br /> Trunk — <br /> Type Fermit: ; _ <br /> Lateral <br /> Remarks: Abutting Lot Line <br /> N S E W it <br /> Approved By ,�-- <br /> c�a eoa�oa, <br /> � • <br /> � Issued 8y - <br /> Inspection By <br /> Date Inspected <br /> SEE SKETCH ATTACHED � N�• ZZB1S <br /> INSPECTION <br /> '_'_. .. .. . .._ . . ._ _ ___ _ ._. _. _. �1V"'.'_" � �� <br /> `� <br />