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� .. . . .--�-�--� <br /> � <br /> I CHART N0. I zC —z l -� I <br /> � . � <br /> everett %���'/� , <br /> � . � <br /> � � c��—,1 : I <br /> � I <br /> City of Everett , • , <br /> Engineering & Community Services � � <br /> � <br /> Sewer Application and Permit ; , <br /> ,-;. ; <br /> � <br /> NO. �' ,_ J J i DATE., ' ' ; <br /> I <br /> I <br /> � ..� Utility Account No. � <br /> Scrvice Address � � �I <br /> Billing Address <br /> Permit Fee � I' 1 <br /> ! <br /> City, State, Zip Co�nection Charge(s) <br /> Total Fee — � � <br /> Uwner (Mortgagor) ' <br /> � <br /> Billing Name I <br /> ' ' y %' ; � <br /> Connection By � <br /> / ", . �� � <br /> Address S�9�ed Customer / <br /> Phone I <br /> DESCRIPTION: Sewer District <br /> Lot Block Monthly Sewer Service i <br /> Plat � <br /> Unplatted Description Monthly Sewer Constr. � <br /> Trunk � ' <br /> Type Permit: �--,•. • .:_.t �, �� <br /> Lateral � <br /> Remarks: Q�� �� + �J<«��•-�- Abutting Lot Line <br /> . I , 4� .�� � S 'l�jr � �_ z.�- N, S, E� W ft. i <br />�'' J/ /� �..�>.. �G � � � <br /> • i <br /> i <br /> , <br /> APProved By� c�cv e�a�ne�, i I <br /> Issued By ' � , <br /> 1 <br />� <br /> I <br /> i <br /> Inspection By �� �-�""'�'�d i <br />` Date lnspected ���/� �/ <br />� o � .� ; i- -� � <br /> SEE SKETCH ATTACHED NO. -' � •? : <br /> IPlSPcCTI0f�1 I <br /> 1 <br />, <br /> ; <br />�d i � <br />