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everett �� `' , . .. ., CI IART N0.�. ���F�—L� � <br /> I ' , �' `� � <br /> � � � (�J �m� �7�� '� � <br /> � ��r �� rs18i � �� ��� ' <br /> Ci of Everett fY I �'� /� , � j <br /> ,. � <br /> tl' I Y .. .. ................ i <br /> �',.I.�. ,'ci[rj",.o,. /� � /' <br /> Engineerinc� & Community Services � U,�p[, / ]�..{J / (, � <br /> / � s ' <br /> Sewer ApQlic�ation and Pe�rmit � ; j <br /> � <br /> � <br /> NO. ; �� ' �:� ,:' DATE ' � i <br /> i <br /> Service Address /�:- � ' ' " Utility Account No. ' i "� ! <br /> Billing Address ' � ' Permit Fee i � � I <br /> � <br /> City,State, Zip ' �� � �� _ Connection Charge(s) ` �U j <br /> � <br /> Owner (Mortgagor) - _ Total Fee I <br /> Billing Name_ - � <br /> Connection By_ i <br /> Address Signed I <br /> . cu:,omci j <br /> Phone - � - ; ' i <br /> —— . � <br /> DESCRIPTION: SewerDistrict '�'' T I <br /> Lot_ 1 � Block ' <br /> Plat � Monthly Sewer Service �� � <br /> I <br /> Unplatted Description � Monthly Sewer Constr. � <br /> � <br /> Type Permit: : Trunk � — �:� <br /> Lateral <br /> Remarks: <br /> Abutting Lot Line � <br /> N, S, E, W_ ft. t <br /> j <br /> i <br /> � <br /> j <br /> Approved By ' ' _ <br /> Ciry Enginccr ' <br /> � <br /> ` �ssued By_ ' -- -� ; <br /> 1 <br /> 1 <br /> � . � <br /> ;a . <br /> �� Inspection By - � '�� <br /> � /' � . ' <br /> - Date Inspected J �- �f i ; <br /> u . <br /> SEE SKETCH ATTACHED N0. �c' C �.. ' , <br /> li�� =i'��r�i i����� <br /> �t� � vN Y"a� t , � � .�'� � ir r� � <br /> �'4YA'S>°_, h✓� _ .1 . __ S.__•� . ... � . . I �._. P.�. .__... _�� � _ `rd �. _..,_. , <br />