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. -- � �.� <br /> m �:, �--- <br /> CHART N0. ` � �� "`-����' <br /> � everett � - ,, � <br /> � � <br /> � <br /> City of Everett <br /> Engineering & Community Services <br /> Sewer Application and Permit <br /> � - I <br /> NO. � �.� � � DATE -"'� f �' `"�7 - <br /> Service Address � �-� L- L"�`��t"�''��' { Utility Account No. <br /> BillingAddress �vf�-�,%���E=_, PermitFee f�C"�"�t-- <br /> City, State, Zi� ��--�-'r ��""_�'� Connection Charge(s) <br /> � r , . <br /> Owner (Mortgagor) ������ `�`�'� �� Total Fee ��—'��-� �,�=-- <br /> Billing Name „����� �= <br /> Connection By �--''�� � �-� �--����—�� <br /> Address Signed �____�„_LJ�- ����.�:�r,/��. 1��� <br /> Customer <br /> Phone � <br /> DESCRIPTION: Sewer District • <br /> Lot Block Monthly Sewer Service <br /> Plat <br /> Unplatted Description � l 'C-���t— � ' �'"�� � � Monthly Sewer Constr. <br /> Trunk <br /> Type Permit: .� IJI-�� (G <br /> Lateral <br /> Remarks: <br /> Abutting Lot Line , <br /> � csuac.- � G � i1, S, E, W ft. <br /> �� vR- T 9 � Cl, a /�' <br /> / ,�, <br /> Approved By�= / - .C'�.<!/l._: �, <br /> City Engineer � <br /> Issued By t' . C�___,.]C..!_ /)/J%:jx..� <br /> Inspection By��� <br /> Date Inspected�� � ^ 7 7 <br /> e <br /> ,� .. <br /> ,FF RKETCH ATTACHED N�• = 4 ; _. •_ <br /> If�15PEClli?id � �� <br /> . � . , '�yr � . �`!�., c `�:?5 - -.._ �� <br /> F <br />