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� <br /> � <br /> CHART N0. --- <br /> everett � <br /> � ��� <br /> ; e <br /> � � <br /> i City of Everett <br /> t � a' <br /> , - <br /> Sewer Application and Permit <br /> No. 2R791 DATE � /� �/� �/ <br /> Service Address.�"Z �Le2z'—" �tility Account No.�---- <br /> � �O <br /> Billing Address � Permit Fee <br /> �°r�r ��'� . g�a2 0� Connection Charge(s) o <br /> City,State, Zip � � � <br /> /�� Total Fee � <br /> Owner (Mortgagor)��� �T <br /> Billing Name <br /> ��QQ D__��� <br /> Connection By���<'w�- <br /> Signed Customer <br /> Address <br /> Phone <br /> DESCRIPTION: <br /> Sewer District <br /> Lot Block ��� Monthly Sewer Service <br /> - - � <br /> Plat 2�r-1 � <br /> Unplatted Description Monthly Sewer Constr. <br /> Trunk <br /> Type Permit: �,�-� Lateral <br /> Remarks: Abutting Lot Line �I <br /> N S E W ft. <br /> ' � <br /> � <br /> � <br /> qpproved By�- �' � I <br /> Ciry Enginccr <br /> I,sued By ' � � I <br /> I <br /> � <br /> — Inspection By�"" ` � 6e/� I <br /> Date I nspected � - � j^��Y I <br /> No. 24791 '� <br /> SEE SKETCH ATTACHED I <br /> fl — IN':pECTION �i <br />