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everett CHART Nn._ - <br /> i � .� �STc� <br /> I a ^� <br /> I City of Everett G- �� � � �� <br /> � Sewer Applicatior� and Per ' ' <br /> m�t <br /> No. 22890 DATE _ / � <br /> Service Address �� n�- / I� i Utility Account No. <br /> Bilting Address Permit Fee_ <br /> _� <br /> City, State, 2ip Connection Chargels) <br /> � <br /> Owner �Mortgagor) Total Fee <br /> I - -- <br /> � Billing Name <br /> � — <br /> i Cr,�nection By_ � �� <br /> T <br /> � Address '� Signed - <br /> I c�:�om.e. <br /> Phone_ <br /> IDESCRIPTION: Sewer District__ <br /> Lot _ Block_ <br /> IFlat Monthly Sewer Service <br /> i Unplaited Description _Mon[hly Sewer Constr. <br /> Type Permit: Trunk <br /> _ Lzteral <br /> F,emarks: <br /> � �iii�utting Lot Line <br /> /i�Dirl rl�l f� ;.0 y.CF N, <br /> , s, E, w rc. <br /> s� .G�ci� <br /> � , � <br /> 't� i'�.v< � � � � <br /> Approved By <br /> QIy Engineer <br /> Issued By _ _ ( . <br /> � --- - Inspection By— -� � � '`� `��1�1�=�/� _ <br /> � — Date InspecLed x - � '� J% <br /> SEE SKETCH AT"rACHED N0. ZZH9Q <br /> � <br />