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icHaRr r�o.�r� '�. u —� r -S <br /> everetl <br /> e -� , � - � . � <br /> ► �- <br /> � <br /> � City of Everett <br /> Engineering & Community Services <br /> Sewer Application and Permit <br /> NO. � �. / ( - �DATE- . J- }'/ - '77 <br /> ��� S ✓,Gl�./�.f! rC�� — <br /> Service Address_ � '��3 0 (/ t1<,Jc...v�� ' • Utility Account No. <br /> Billing Address� -�- Permit Fee_ P�J �'�.: <br /> C° +� G <br /> City, State, Zip i�-«'r�:� /�.,t,r�ti 7,f'y-�/ Connection Charge�s) <br /> Owner �Mortgagor) � � i,�f.r .c,,. 4 �,� N,;f <br /> t' , ..y�' Total Fee �' <br /> Billing Name -/�tt��Yf u.- <br /> Connection By ��'t .��-/ .c��'� � <br /> �. �� � <br /> Address Signed �'`��'-�, rY�1�l-n`���,c�- <br /> Customer <br /> Phone <br /> DESCRIPTION: Sewer District <br /> Lot � ' � � Block 3 E'Sf <br /> Plat ��_r�l- ��/� Monthly Sewer Service ! <br /> Unplatted Descr:�tion _ Monthly Sewer Co�str. � <br /> —F Trunk <br /> Type Permit: ,�„�...y.� ��,,�.�� <br /> Lateral <br /> �Remarks: v.0 n< / <br /> `� ��( � �-i--.�G� 'f-+c� �:Z.c.r•�_� Abutting Lot Line <br /> �� Y�. � �/�!! ,, l �,c /1'/ N, S, E, W ft. <br /> iL-xJ �/l''1 <br /> i <br /> A , I. <br /> APP�oved By �i 1J '7n'1cY`� <br /> - City Engineei i <br /> � -9,,/ � � � <br /> Issued By_ c . 1G .,��Tu+ `� <br /> , � <br /> Inspection By�:�, �.�:1--7� <br /> o — __ i Date I nspected ���- Lf ^- `7 `7 <br /> � <br /> SEE SKETCH ATTACHED NO. ;' ' <br /> � li '::i'I-1;IU�ih�i ,,� . . � . <br /> f >� , � <br />