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CHART N0. TS ��4"=� 7-.� i <br /> ; <br /> everett � <br /> ., <br /> � -, � �� � ' <br /> � � � <br /> City of Everett i <br /> Engineering & Community Services " � <br /> i <br /> i <br /> Sewer Application and Permit �, . ' <br /> � <br /> � <br /> NO. 7 2 3 �� O DATE ' - •' �' � <br /> I <br /> Service Address -^'' ' � Utility Account No. <br /> Billing Address Permit Fee - ; <br /> i <br /> City, State, Zip Connection Charge(s) ' <br /> I <br /> Owner (Mortgagor) Totai Fee - � <br /> i <br /> i <br /> Billing Name � <br /> Connection By f � <br /> i <br /> �ddress Signed_ • i� __ _ � i <br /> Custamer i <br /> i <br /> Phone_ __ � <br /> DESCRIPTION: Sewer District � <br /> Lot _ Block <br /> Plat Monthly Sewer Service ; <br /> , <br /> Unplatted Description Monthly Sewer Constr. � <br /> I <br /> — Trunk � <br /> Type PermiC --� . , <br /> Lateral � <br /> i <br /> i <br /> Remarks: � _2,t_�v �. S . � �b.Z` +ti y��utting Lot Line � <br /> ".:Cc r ��� �y ��(� � � //� / N, S, E, W ft. s <br /> �rL . � ,� � � <br /> 1 <br /> Approved By =" i <br /> City Enginecr <br /> Issued By I <br /> 1 <br /> � <br /> Inspection By �� . _a _ � � <br /> _ Date Inspected ] —;}=7� ' I <br /> 4 ; <br /> SEE SKETCH ATTACHED NO. � <br /> ,, ,,, , i , � <br /> I <br />