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V11I1111 I��l�._. _ ... .._ __. _ _ . . . . __ <br /> everett <br /> e � ��L,,�` � <br /> �-Z� ��+- <br /> City of Everett <br /> Sewer Application and Permit <br /> NO. 24136 DATE r�5/8! <br /> 1616 Oat�• /Fi 1 <br /> Service Address 7 .kro �� c Fc�L�itU4ility Account No. <br /> Billing Address Permit Fee �O°� <br /> City,State, 2ip Connection Chargels) <br /> Owner (Mortgagor) Total Fee �o�� <br /> Billing Name <br /> Connection By_ Citr of E��r�tt <br /> � Dl11 tatS�MaY <br /> Address Signed <br /> ca:comer <br /> Phonc <br /> DESCRIPTION: Sewer District <br /> Lot Block Monthly Sewer Service � <br /> Plat I <br /> I <br /> Unplatted Description Monthly Sewer Constr. � <br /> Type Permit: <br /> Trunk <br /> Lateral <br /> Remarks: �f�"/i��(/ �.>� ir-- _S./) �'o -ri in...� I <br /> / Abutting Lot Line <br /> f�. $��i�lrji . .Jn�: i��/ (� ia�, t`° �r•��a .,r.� % �`f�i N, S, E, W fi. � <br /> ,� <br /> i/r , � r .< ">-�� �ir/� i• �!/. /-/. .. ,t �r /_6 . <br /> i <br /> �f�"/ 7 �n .a ., i� �..�- Cr-.� .�._e.e..I•-r-rc.. ,/�� /U• c �. R. ?h�al <br /> / 'l y • / ' APProved By <br /> ///. �7 �' 7 i /(L�/v City Engineer <br /> !. 11c:_3 <br /> Issued By <br /> I <br /> - ;��� ��ti.�.�.�� �� � <br /> Inspectio� By <br /> Dateinspected �-�-S�y � <br /> SEE SKETCH ATTACHED i N0. 2413v <br /> INSPECTION � �. <br /> I . <br /> � <br /> � <br />