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CHART NO.�' ,. ' � <br /> everett " <br /> J`r ^ I <br /> � 1 (_`S�� ; <br /> `"1�a0��� <br /> City of Everett _�/ I� <br /> - I <br /> Engineering & Community Services � <br /> Sewer Applicction and Permit j <br /> f ; <br /> � <br /> N0. � f �� I. � DATE � � � � <br /> � � <br /> �,;��� 7(•c3 , ��E���Y ��c4'-ecl'.• <br /> . <br /> Service Address i'� �` ` • Utility Account No. ? - -" " ' '' " ; <br /> , ;<.,� <br /> Billing Address � --� '�'' ` '�• Permit Fee � _ <br /> i <br /> City, State, Zip ��' � � i Connection Charge�s) ' ��' � ' � <br /> .. `'� � <br /> Owner (Mortgagor) � '� ^ '.:�Jotal ( ee C G <br /> Billing Namo � "'� , <br /> Connection By �" i� <br /> �I � ,I <br /> Address Signed, f'���`` � <br /> � stomcr <br /> . � — `�.. /.; <br /> Phone � 3�' — ' <br /> DESCRIPTION: Sewei District � L - -�-�— <br /> ,i �— <br /> Lot �Block / <br /> Plat �r /' � — . Monthly Sewer Service <br /> � _ <br /> Unplatted DescEiption Monthly Sewer Constr. . 1 <br /> . :.<+' <br /> Trunk • ' <br /> Type Permit: • i..,�- <br /> Lateral - � �' <br /> Remarks: <br /> Abutting Lot,,Line <br /> N,, g, E, W ft. <br /> � <br /> Approved By� •'� � <br /> — City Engineer � <br /> — Issued By ' � <br /> Inspection By ' - '�''"�'�"'"� <br /> Date Inspectea3� , �� ?� � <br /> 0 <br /> SEE SKETCH ATTACHED �!0. � <br /> IDIr,'!-. ; I' . � <br />