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� <br /> i <br /> � <br /> 1 <br /> i <br /> , <br /> ; <br /> CHART NO. <br /> everett <br /> �. , .� 1- c. ,, �?1� S/:/�-r <br /> e <br /> City of Everett <br /> Sewer Application and Permit <br /> No. 26235 DATE s�.�+Q 16 1�7 <br /> Service Address � � – Utility Account No. <br /> Billing Address Permit Fee . <br /> C�ty,State, Zip Connection Chargels) <br /> Owner (Mortgagor) Total Fee _ <br /> Billing Name <br /> Connection By — <br /> Address Signed � <br /> Customer <br /> Phone <br /> DESCRIPTION: Sewer District <br /> �ot Block Monthly Sewer Service <br /> Plat <br /> Unplatted Description Monthly Sewer Constr. <br /> Trunk <br /> Type Permit: �qration <br /> y; Lateral <br /> Remarks: e <br /> butting Lot Line <br /> N S, E. W ft. <br /> � � <br /> Approved By <br /> C x�. , ., . !D][b�N�'t�7 Fki : <br /> IMPORTANTI � <br /> Issued By � �'�`''S <br /> CALL1-800-024-555546-HOURS ;[ t_ S10,Ca? <br /> PRIOR TO DIGGING �;i��H '+1U.UD <br /> CALL 2595811 FOR INSPECTION <br /> Inspection By <br /> Datelnspected <br /> SEE SKETCH ATTACHED No. 26235 <br /> If�SPCCI"ION <br />