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everett <br />e <br />City of Everett <br />Engineering & Community Services <br />Sewer ApplicatiQn ��nd Permifi <br />,._ <br />NO. �� �'� WJ DATE I /� /� . <br />= i r�t%%�_.l � ��� r �. <br />Service Address � 1 <br />Dilling Address.�' ' =�� ���� �'r r�"', �" <br />City,State,Zip t � C--ii'L-I'T lf ��` %�L('/ <br />Owner (Mortgagor? /l1 %� «- ` ��� �� <br />Billing Name �=l�7%1LC /��i-"�J <br />Connection By � l /'�'L� ��'�'• T,�' _ <br />�- <br />Addresst��'� � L ( `` )`� <br />Phone �� ��I _ �Jp / `� <br />DESCRIPTION: <br />Lot "/. ��c�1 7 Block ���� � <br />Plat C_: C_.Kf- )T L i� ���� �� � � T <br />Unplatted Description__ <br />CHART NO.r�'s7�=�� � <br />s Ta �'L �'`C. <br />Utility Account No. <br />Permit Fee <br />Connection Charge� <br />Total Fee <br />��c����� <br />_ <br />Signed - �-_ � � .�. t' , <br />Cuslomcr �—_. <br />Sewer District <br />Monthly Sewer Service. <br />Monthly Sewer Constr. <br />Trunk <br />Lateral_ <br />Abutting Lot Line <br />N, S, E, W_ <br />SEE SKETCH ATTACHED <br />o � <br />� �, �: ; , :, . <br />Approved By l.. i ��..�-'a-7i'�' �/ <br />Ciry Engineer <br />IssuedBY `" ('r'��-L i�c��i.<- <br />Inspection By ����G="�^-� <br />Date Inspected '� �'��7 J" — <br />• <br />�, , � e;� i, �'r''�P t� <br />