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CHART NO. 1� Zrf "Z/�'S _ <br /> everetl <br /> e - ��r�,: <br /> City of Everett ; , 7�, <br /> , , � G / <br /> Sewer e''►pplication and Permit �', <br /> No. 23281 DATE --- <br /> Service Address� � Utility Account No. _ -- <br /> / �� ' <br /> � ( 6 �� Permit Fee � `"� <br /> Billing Address - - <br /> City, State, Zip ' � Connection Charge(s) <br /> /� s'ff <br /> Owner (Mortgayor) l� � /`/' �-,cl�'.b` - Total Fee ��� - <br /> � <br /> Billing Name - / <br /> Connection By �-. � <br /> � / � � <br /> / �"' � ; �� <br /> Address -- Signed_!-___:_(_ ` <br /> � r.�„����:��, <br /> Phone —— - <br /> DES RIPTION: Sc�ver District---- _____ _-- _--.----- <br /> Lot� B �k � ����. Monthly Sewer Service_ <br /> Plat ��i!� � - - - - ----- <br /> Unplatted Description Mon[hly Sewer Constr. <br /> Trunk_. _---__-_- <br /> Type Permit: i <br /> Lateral <br /> Remarks: ,(� � !iJ r-� "` Abutting Lot Line <br /> % f t. <br /> C ,-'n.1�"-,� t�t�y%�_ _ N, S, E, W — <br /> � �1�: G <br /> ApproverJ By <br /> Ciiy Engincer <br /> — Issued By . <br /> — Inspection By '�— <br /> - � <br /> Date.lnspected � " � <br /> ---- - --- --- L_ _, -%a . <br /> SEE SKETCH ATTACHED G3Z�� <br />