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I <br /> _ � - �� S s <br /> CHART N0. � � ` ' � <br /> I everett r <br /> � <br /> � �� �� � <br /> City of Everett � I/��f i <br /> �13 <br /> Sewer Application and Permit � <br /> NO. ZZp94 DATE ���. �� % '/ <br /> I <br /> Service Address ' ��� � Utility Account No. � �—' � � _'> � <br /> i <br /> Billing Address �'•� � Permit Fee � �� 'r �' � J <br /> City, State, Z�p =-- Connection Charge(s) � �� ' � � I <br /> Owner (Mortgagor►'�- ` " � �' --: , /. . Total Fee `� � <br /> Billing Name �_ ^ ,� �: �� � I <br /> Connection Byi= , t . i:..�. „�% �i . �e:r ,ir �.,s� . �-�� r . �_ . ' <br /> / <br /> Address "l-` ' i.L i< c. t..� ���� �_ Signed �' � I <br /> cuswmer � <br /> Phone —� � � I <br /> DESCRIPTION: � <br /> Sewer District � � �-- � � -l— � <br /> I <br /> Lot Block � , <br /> Plat Monthly Sc�Ner Service � -' i <br /> Unplatted Description Monthly Sewer Constr. I <br /> � -1 <br /> � , � c._ � t— l < <_. — r., _. <br /> Type Permit: Trunk �- ' �- �-- ' <br /> I <br /> Lateral ���" � �- I <br /> Remarks: ; /_1 �. ,!c ,_. ,-., c � , �� ti- <br /> Abutting Lot Line � <br /> N, S, E, W ft. � <br /> I <br /> Approved By L . ���._ �.-" '- � � i -- <br /> City Engineer <br /> Issued By � . ��-: cc ,, •. : , .�, �� I <br /> � Inspection By <br /> � � i <br /> Date Inspected � -�a —�7 <br /> SEE SKETCH ATTACHED N0. ZZ�94 <br /> � I�dSf'P�110N <br /> �' <br />