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� <br /> CHART N0. G ��2q-S <br /> evered <br /> � <br /> City oi Everett <br /> Sewer Appli�at�o� and Permit <br /> i.� c �_ <br /> N0. 2�873 DATE <br /> 7 . � �� � Utility Account No. v= <br /> Service Address � � �`7 <br /> �w Q , Permit Fee <br /> gilling Address� �/ n !' / <br /> �� � ) Connection Chargels) � <br /> City,State, Zip_ � �� _ <br /> � � �„ , _ Total Fee <br /> pwner (Mortgagor) • <br /> Billing Name °`� <br /> Connec'ion BY,----- <br /> Signed Cusromer <br /> Address <br /> Phone <br /> Sewer District <br /> DESCRIPTIUN: � I <br /> Lot x ', �; Block�-- ; � �y �, ,�`- Monthly Sewer Service <br /> --�- _.___ -_ �l�e/,l-i�• � <br /> Plat_ Monthly Sewer Constr. <br /> Unplatted Description I <br /> Trunk ; <br /> I � � <br /> Type Permit: Lateral <br /> I <br /> r� � <br /> Remarks: ' Abutting Lot Line ft I <br /> , � N S E W <br /> Ii <br /> qpproved BY ��' �'�4 J� <br /> Cii E�gineer � I I <br /> �' '��! <br /> „ <br /> Issued BY� <br /> � <br /> �-- / <br /> ------- �� //i G- <br /> ' i Inspection BY <br /> � ����''r �=F `,( -_ '' <br /> �� , , <br /> I Datel�spected <br /> No. 23873 <br /> SEE SKET�H ATTACHED <br /> IINSPECTION <br /> i — <br />