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1 <br /> � �nran i ivv. � <br /> everett 0 - ; <br /> Q; i <br /> � , .. 1 <br /> i...., _ ,� � <br /> � � �_. <br /> : <br /> '� �': r <br /> S .., .-� <br /> C' • • � <br /> �r- <br /> City of Everett -� � ; <br /> Engineering & Community Services j <br /> :,•. ' ' <br /> Sewer Application and Permit ,`� i <br /> ; <br /> � <br /> No. 22472 DATE J -= " �� ' <br /> t <br /> ; I, <br /> Service Address �'��'�� '' '' �"^"� t '-'"� • Utility Account No. I <br /> �, �% I <br /> :-�(,'_ ' . i �r� // Permit Fee )� <br /> Billing Address - <br /> . � _�-- <br /> City,State, Zip- � '_ � =�'� �� ' � `'-� Connection Charge�s)_ <br /> � <br /> Owner (Mortgagor)i '' � / � � �Total Fee J '� ' <br /> BillingName '�'' .-J `'�� " _ ; _ �"Jr � <br /> Connection By `�""' � !� ; <br /> / . <br /> Address Signed ' � -1 <br /> , J f„/ �Customer � <br /> i <br /> Phone = `- ; // " � - ^ I <br /> . i _ ^ i/ , - <br /> DESCRIPTION: %'� �� � " " � SewerDistrict j <br /> Lot_..T— Block� �, <br /> � . � Monthly Sewer Service <br /> Plat f - % � <br /> Unplatted Description Monthly Sewer Constr. � <br /> Trunk � <br /> Type Permit: � <br /> Lateral <br /> Remarks: Abutting Lot Line — ,� / ; <br /> N S E W • r ft. <br /> � <br /> ApprovedBy�.., .. __ : "/.. � <br /> Ciry Engincer �� , <br /> Issued By � - - '1 <br /> Inspection By <br /> � • <br /> � Date Inspected <br /> � � SEE SKETCH ATTACHED NO. �Z Z 4_T Z �� <br /> � INSPECTION <br /> � <br /> �+,_ <br />