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everetl CHART NO. �?�" �' %" -.s <br /> e � <br /> ,os�o <br /> City of Everett l��_�7� <br /> � �/ <br /> Sewer Application and Permit �� <br /> N0. 23a7Q DATE �iann�r_v_7;� lOR(1 <br /> Zi�S <br /> Service Address � Roc�� � Utility Accouni No. <br /> Billing Address Citv of vwr.rr Permit Fee None <br /> City, State, Zip Connection Charge(s) N,QnP <br /> Owner (Mortgagor) Total Fee rJon • <br /> Billing Name_ Citv of Fv..rorr <br /> Connection By <br /> Address Signed non Ui 1 ' nr <br /> Phonr. a„�o�„�, <br /> DESCRIPTION: <br /> Sewer District <br /> Lot Block <br /> Plat Monthly Sewer Sen�ice <br /> Unplatted Description Montt�ly Sewer Constr. <br /> Type Permit: Trunk <br /> Lateral <br /> Remarks: — _ <br /> Abutting Lot Line <br /> N' S" E' W ---- (t. <br /> � , , , , h � . <br /> _ Approved By <br /> itv' nginccr ' <br /> Issued By <br /> i <br /> i <br /> Inspec[ion By <br /> -- — — Datelnspected ' � ' <br /> ; SE[ SKETCH ATTACHED N0. L347A <br /> IIJSi'L('TION <br />