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r.—r -. . � ' i <br /> � <br /> , CHART NO. l� zG'' �/�---s- I <br /> � everctt _> <br /> � � � �i ds�� � <br /> ► <br /> � � /� 7� <br /> I City of Everett \ � � /� <br /> I • a � • �3 <br /> , Sewer i4pplicataon c�nd Permit <br /> � <br /> No. 23044 DATE % i - .� f � <br /> Service Address r ' <br /> �_ Utility Account No. � <br /> Billing Address Permit Fee — — ' <br /> r — <br /> City, State, Zip � Connection Charge(s) <br /> Owner (Mortgagor) Total Fee I <br /> Billing Name I <br /> Connection By ~ � <br /> i <br /> � Address � Signed <br /> c�rsrome, <br /> Phone <br /> DESCRIPTION: <br />� Lot � Sewer District <br /> Block <br /> Plat Monthly Sewer Service I <br /> Unplatted Description Monthly Sewer Constr. ' <br /> � � <br /> Type Permit: Trunk ! <br /> Lateral <br />� Remarkr. ij,� � rc� '� < � '_ � <br /> �- � �� Abu[ting Lot Line I� <br /> � � ,�/ �� . /fl. ,�-f /� E�/ N, S, E, W ft. � <br /> i i' / <br /> � <br /> � <br /> Approved By � <br /> I QlY Engmecr I <br /> I <br />, Issued By " �� � <br /> � <br /> � � Inspection By %-�'l� %//r ; �< •� � <br /> � Date Inspected / —// -�_ <br />' I SEE SKETCH ATTACHED No. 23044 <br /> , <br /> , iNsr�Fcriori <br /> � <br />,.,�.. _ � <br /> � <br />