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CHART NO._�_�_/ � � <br /> � � <br /> � <br /> evereri j�s / L- � , i <br /> � �— /O — � � '', <br /> City of Everett ,�f.!//� • . <br /> Engineering & Community Services . <br /> Se�nrer Application a�d Perrrsit ; <br /> , - � � <br /> N0. ;1� � J �� .i_ DATE <br /> `�%=, �/�r' � <br /> Y iJ � �_,^_ � � l Utility Account No. � <br /> Service Address �' I ' <br /> . 1 i.%l <br /> Permit Fee �%'� i <br /> Billing Address — � <br /> Connection Chargels) <br /> City, State, Zip_ , ,�� <br /> Total Fee '•4' ' <br /> pwner (Mortgagor) <br /> Billing Name <br /> .r �� �-- <br /> Conner,tion By �--� � f y I <br /> , � - : � • <br /> � ��.. .��.]-1A-_. : <br /> Address Signed���s�omcr <br /> i <br /> Phone + <br /> Sewer D�strict � <br /> DESCRIPTIO�J: ' <br /> Lot Block Mo�thly Sewer Service i <br /> � <br /> Plat � <br /> Unplatted Deicription _—_Monthly Sewer Constr. ' <br /> i <br /> Trunk � <br /> � !: � I <br /> Type Permit: ;+ , �^.,�� . — Lateral <br /> i <br /> t <br /> — � <br /> Remarks: - n Abutting Lot Line ft. � <br /> �w.�.i-[ �- �� do �.7�tl�C— N, S, E, W <br /> •s. 1 <br /> �� ���' G{'cc a� � � , <br /> • � � � � ' C�c � <br /> �-�,L Approved B�Y ' . " ' i <br /> City Engineer � <br /> �,�� . %'�� � <br /> . ,.?..-.,_ . <br /> ISSUCd BY ��� + <br /> � <br /> � <br /> � <br /> — Inspection By � <br /> Date Inspected � <br /> — , . 1 <br /> u No. - I <br /> SEE SKETCFI ATTACHED �,�.�y.; <br /> � f�� �� , <br /> 1i��51'� i'1 P;`6: � :k rr� �. . . .. <br /> 4 i1- , el. �°t� '� ."�'T1,4v,L,t,:a.\ahxx .. � <br /> a»..�_`,. , . .. _:xa .,... ,. <br /> :.!?��-.� . . � . ,. <br />