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CHART NO.�'���– '�� � � <br /> evere!1 <br /> ����� G� <br /> e , �> -5_� � <br /> City of Everett �`� <br /> Sewe�r Application and Permit <br /> No. 23219 DATE '�/,7�_,�� _ _ <br /> Service Address �(1�9 �.1�.�.l���C�i- Utility Ar.count No. <br /> O <br /> Bdling Address Pen-.ii Fee <br /> City, State, Zip Connection Charge�s) <br /> Owner (Mortgagor)_ Total Fee _ <br /> Billing Name <br /> Connection By _ <br /> _ . � <br /> Address Signed <br /> a„���„�„ <br /> Phone <br /> DESCRIPTION: Sewer District <br /> Lot� Block <br /> Platle{�t!_J C� s�' � �(L�=/S/-7f Monthly Sewer Service _ <br /> Unplatted Description Monthly Sewer Constr. <br /> Trunk <br /> Type Permit: — <br /> Lateral <br /> Remarks: <br /> Abutting Lot Line <br /> w N, S, E, W __ ft. <br /> —�� `�o a ��� . <br /> Approved dy <br /> c��v e�,y��,�,��. <br /> Issued By <br /> i <br /> Inspection By� ��� `'��_ <br /> -�2 �/ <br /> __ _ ___ __ _ i Date I nspected��(� �� <br /> SEE SKETCH ATTACHED N0. 232�J <br /> ! ,: LCi �C,� <br />