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�� <br /> everefl CHART N�'���T <br /> � � <br /> ��G 3 T�''`'Q + <br /> City of Everett / � �' ��� <br /> I <br /> Sewer Application and Permit / � 6' �'� <br /> N0. ZZH36 DATE ' ' ' <br /> Service Address _ Utility Account No. I <br /> 8illing Address Permit Fee <br /> City, State, Zi� Connection Charge�s) <br /> Owner (Mortgagor) Tot;:l Fee I <br /> Billing Name I <br /> Connectian By <br /> I <br /> ' � I <br /> Address Signed � <br /> PIlOf18 _ Customer i <br /> DESCRIPTION: I <br /> Lot Sewer Distric[ _ I I <br /> Block i <br /> Plat A9onthly Sewer Service__ I <br /> Unplatted Description_ Monthly Sewer Constr. � <br /> i <br /> Type Permit: , Trunk � <br /> . , <br /> lateral I <br /> Remarks: � � � S , � <br /> `] - � �r ^"� "' Abutting Lot Line � <br /> ` a i(�� c . ' c ,. // , �;. N S E W I <br /> % ii//.-�a/ <br /> — fL <br /> Approved By <br /> City Eng'�nccr I <br /> Issued By <br /> I 1 � <br /> i <br /> I _ __ Inspection By—�=f ����G�^ «--� I <br /> — ------ —__�Date Inspected_ /- /7 - i�f � <br /> SEE SKETCH ATTACHED NO. ,2283� � <br /> I � I <br /> I INS!'FCTIOf� <br /> i <br />