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:;�: <br /> � ev�erett I CHART NO.� � ' `� <br /> �o s T cr� <br /> � � <br /> City of Everett I <br /> Eny neering & Community Services <br /> i � <br /> ' Sewer Appl�cation and Permit <br /> ,,_, , - <br /> NO. DATE _���j' `� -- <br /> i /� — <br /> Service Address__��� r' � Y �r�.V /l��.t:.+- /J,e� Utility Ac,:ount No. <br /> ; Biilin Address� ��// N� l Pr�> �� '�� <br /> 9 Permit Fee_ <br /> I ��/,eL'L��.« <br /> , City, State, Zip_E�-�d�=�«�ss����3 Connection Charge(s) l <br /> � <br /> i Owner (Mortgayor) � ��•� �7 � �"� I'Sorf -��� J=' <br /> Total Fer.__ .J�_ <br /> ! Billing Name�J/ �vl �i,c.,y��•/ <br /> i <br /> ! Connection By / G ?�(�E �_�� �f_,G <br /> . <br /> Address_��id7_ /0-rj.� -�,y'j"� �it.lp Signed <br /> c��s���„�, <br /> Phone—�Cs�� � �i� . <br /> I DESCRIPTION: SewerDistrict — !��"�,:L c�(� _ _�;_�� <br /> Lot 4S Block ' <br /> Plat_ ��� �- � r���i-.»: }\p�, � c�/ Monthly Sewer Service._=-_��=' __ <br /> � Unplatted Description <br /> i Monthly Sewer i;onstr. <br /> i <br /> Type Permit: (I�J��i �'�Y�:-c i�oN ��w> Trunk_ _ _ <br /> . <br /> � Lateral <br /> Remarks: <br /> I Abutting Lot Line <br /> N, S, E, W-- — it. <br /> � - <br /> Approved E3y <br /> — Gty Eugine�•r <br /> _ � J '_ <br /> Issued 8y ��� •z-''/�:. —. <br /> �`— — <br /> / <br /> Inspection By �—� <br /> o Date Inspected_ ��� <br /> SEE SKETCH ATTACHED Np. ) i �; ; <br /> � <br /> _ �._�,__ . �i�i�,pc,^7�'��: - <br /> r <br /> 3 . - - LL T�. . . . , " "11� r�.4.. . . <br /> . . . . . a�. , . . <br />