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i <br /> CHART NO. <br /> CVFr�11 <br /> -r o �s�tr.r� <br /> � � <br /> �-96-30 <br /> City of Everett <br /> Otiiub/"11 1:21in OOIb�iS0r;R1 �f': <br /> Sewer Applitation and Permit �"f� <br /> ��f� �._.o.�� <br /> cO �_i�sH t,tt.�rc� <br /> NO. ��voS DATE <br /> I Service Address Utility Account No. <br /> � Billing Address Permit Fee�� <br /> City,State, Zip n.�+-�** v� �+�08 Conneciion Chargels) <br /> Owner (Mortgagor�_cr ... m.� . Total Fee , <br /> Billing Name <br /> Connection By r" <br /> Address Signed_ c�:�o�� <br /> Phone <br /> DESCRIPTION: Sewer District_ <br /> Lot Block Monthly Sewer Service <br /> Plat <br /> Unplatted Description Monthly Sewer Constr. <br /> Trunl: <br /> Type Permit: <br /> Lateral <br /> Remarks: Abutting Lot Line <br /> N S E vy ft. <br /> Approved By �'R�' 'T^T� n <br /> Ciry Engineer <br /> I IMPORTANTI Issued BY T_Sflc'"am'� <br /> CALL 7500-024•555548-HOURS <br /> PRIOR TO DIGGING <br /> I CALL 259�8811'FOR INSPECTION <br /> Inspection B <br /> Date Inspecteu � � � <br /> SEE SKETCH ATTACHED N0. 27�g� <br /> INSPECTION <br />