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11 <br /> _ __� <br /> � C� ���-4a7^. ,�. <br /> CHART N0. - <br /> everett <br /> e <br /> , City of Everett <br /> Sewer Application and Permit <br /> N0. 24743 DATE �/27/g7 TaSfmd KB Z -/o-8X <br /> Service Address��n Z / 1 UC--K�' Utility Account No. <br /> Billing Address, <br /> ��y /�G�G� Permit Fee (L� � <br /> City,State, Zip�v�C� ���/ �nnection Chargels) <br /> Owner (Mortgagor)_ ' Total Fee <br /> -�G �' <br /> Billing Name <br /> .r � i �/ / : . ,� ) <br /> Connection By ' � <br /> 1�. � �� ' <br /> � <br /> Address � � ' � ' j� f Signed c�s�o�,�e`l <br /> Phone ' � <br /> DESCRIPTION: Sewer District <br /> �ot Z7-3Z eio�k z� <br /> � Monthly Sewer Service <br /> Plat'r��F� U��/ <br /> Unplatted Description Monthly Sewer Constr. <br /> Trunk — <br /> Type Permit: � — <br /> Lateral <br /> Remarks: Abutting Lot Line <br /> N S E W_ ft. <br /> Appraved BY <br /> �' Ciry Engineer <br /> Issued By `-- /F( ( i��'' i r i��� <br /> , Inspection By�� "'�d F�^'74"' I <br /> Date I nspected �' 3�- F y <br /> SEE SKETCH ATTACHED N�• Z4T43 <br /> . INSPECTION <br />