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CHART N0.— — — <br /> everetl ' <br /> U "� _ �/ ,ga- <br /> � ('J� , q <br /> City of Everett , • "",� '� �,�. � I <br /> C.!LA Ci� Clr�:(;kJ.l <br /> __ _-- <br /> Sewer Application and Permit ��� � ��� . �; <br /> , � <br /> � <br /> i ;. � � � � � � i�� ' � <br /> NO. Z�127 DATE .' � ' -- -- H -.� <br /> Service Addre;s_��a /a Utility Account No. <br /> / o��- <br /> S � - Permit Fee � �I <br /> Billing Address — <br /> �P�'� Connection Chargels) � <br /> City, State, Zip �y-. /�" ����/ � I <br /> � <br /> Owncr (Mortgagor)�� � � Total Fee_ _/Q <br /> Billing Name� '� � '� <br /> ` tR,C�',, / <br /> Connection By —`� <br /> I Signed � � <br /> Address Cus�omcr I <br /> .'�—�a—�L� I <br /> Phone� — <br /> DESCRIPTION: . Sewer District II <br /> i �at B� Monthly Sewer Service 'i <br /> Plat - .� ! <br /> Unplatted Descr' tion Monthly Sewer Constr. I <br /> � <br /> ; ' Trunk — i <br /> I Type Permit: �c.tN <br /> Lateral � <br /> � _ i <br /> Remarks: � <br /> � Abutting Lot Line � <br /> � — � �� � h� 5• E� W ft. i <br /> � <br /> �� � —'���� � ,P " � 's(,,� � <br /> ���'�t__iY�`f�-_._ w �.r_i:,. • � / , 1 <br /> � �� - ; <br /> ( — ApPmved BY,6 � � � I <br /> Ci y En9lnccr � <br /> I - � <br /> I � � � �� <br /> � <br /> � Issued By �i �--�' '� -- � <br /> �'' �— <br /> ' J <br /> / <br /> r .�'— /��`�l � <br /> / F � a'i ; � Inspection BY-- � <br /> � /''.1�1' t' Y"` • Date Inspected_ ---- � <br /> .x.-�- <br /> -��� � � <br /> SEE SKETCH ATTACHED N�• Z41L7 I <br /> 'i <br /> I_ <br /> INSFE�TIGN I <br /> I <br /> �. � <br />