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CHART N0. � `� � � � " � <br /> everen ' •K ' <br /> � � ' <br /> City of Everett �� <br /> Sewer Application and Permit <br /> No. 23433 oaTF --;�....r�_-�^���>-- ' — <br /> Service Address�;���� +- Utility Account No. — <br /> Billing Address Permit Fee ��+0�� <br /> City, State, Zip Connection Chargels) <br /> Owner (Mortgagor) Total Fee_____��`C,til=-- <br /> Billing Name — <br /> Connection By — <br /> Address Signed__��i._�����_---- <br /> Phone <br /> DESCRIPTION: Sewer District __---__ <br /> Lot Block MonthlySewerService _ ____.__--.___-- <br /> Plat <br /> Unplatted Description Monthly Sewer Constr. <br /> Trunk _ <br /> Type Permir. � <br /> Lateral <br /> Remarks: <br /> Abutting Lot Line <br /> N, S, E, W it. <br /> Approved By _ <br /> . 91 <br /> -- � <br /> Issued By <br /> � ' n <br /> Inspection By �� <br /> Date I nspected ___ _ _ <br /> SEE SKETCH AT'.-l�CHED fJO. '234�,3 <br />