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� <br /> . <br /> everett CHART N0. �'^ZO Z'�� r� ! <br /> � , ��4 S ��-r� 1 <br /> /m - ?' -; 7 $ ' <br /> City of Everett /� , <br /> Engineering & Community Services -w <br /> Sewer Applicotion ond perrnit <br /> N0. `�2 � ( �j DATE 1 �//j� � <br /> Service Address._� � f C --`' . yt- ` <br /> `_._ _�� , Utility Account No. <br /> --, <br /> BiNia�_ .:' -3 .n' O r"l', ;-c�1 Permit Fee -.',..�,,:-.`-_ <br /> CitY. State, Zip_ - ' - - — _ <br /> Conneciion Charge(s) �- " <br /> Owner (Mortgagor) Total Fee � _�. <br /> �.._.. <br /> Billing Name . <br /> t • . � <br /> Connection By (� _..,�;. !' '�'- <br /> >r�.. � , <br /> Address r�� �'` <br /> Signed C..:.-::,C.-/ _�._ __ ' � <br /> PhO�e . Customer <br /> DESCR�TION: � <br /> Lot %�' %- � ,-- -7 Sewer District <br /> � Block�> � -� <br /> Plat %'J,� ?�- :� ;��. r ��`� j�,� MonthlySewerService <br /> Unplatted Description <br /> Monthly Sewer Constr. <br /> �� <br /> Type Permit: �.,.:��,, .� Trunk , <br /> Remarks: � � Lateral <br /> a'�t,C� 2 � .�. � ��'�'L � <br /> � � -y � � / , � Abutting Lot Line <br /> " '� — N, S, E, W <br /> f t. <br /> i <br /> I � <br /> �% � . <br />' � �pProved By�' � :'��.;.. : . , _ � <br />, City Engineer i <br /> . '��� -^-� � <br /> � Issued BY=n - � �!�-;._. <br /> I —_�_ <br /> i <br /> i <br /> f <br /> r . � <br /> �4 Inspection By �t � ��_��,y.�. <br /> S <br /> � o Date Inspected__ J - ( .• y � <br />� i SEE SKETCH ATTACHED <br /> ' INSPECTIOPJ N�• ��1 i J <br /> ` t" �,s: � .•�"�. . '€f.�. ° � .��.�.,,� '• rr3;. <br /> , �i.��., �. <br />