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everett <br />� <br />City of Everett <br />Engineering & Community Services <br />� r� <br />CHART N0. � - - -� -�� � �' <br />� �� <br />Sewer Application and Permit <br />, _( -___� � , �, � <br />N0. � _i �U J. :' DATE t-' <br />Service Address l��-r l( �_ l.( G k=t_:'E:' Utility Account <br />Billing Address � '-"-'��N� �- <br />�-- _}C=:= � r <br />City, State, Zip �vl_-1=-C:��T7- �_C ' � <br />Owner (Mortgagor� L ��1�41 �\' :- _-� l_3�_C.C.. �.. <br />Biiling Name ----'j `��.�( �_ <br />Connection By C-� � ( � �-•`r� �����-�--"'��r <br />Address <br />Phone <br />DESCRIPTION: <br />Lot L' � j Block. � z- <br />Plat ��;: � i : [�� '_ I `-'T' <br />Unplatted Description <br />Type Permit: �. �l" � � � <br />Permit Fee �v� �"l�` <br />Connection C <br />TotalFee ����''-�� <br />Signed i_..L�.l L,. �_.; 1c� C.`�.: ;l(. � <br />Customcr <br />Q <br />SEESKETCH ATTACHED <br />. � ' : <br />l.�: �I. A f•. � . . . ' . ':.. <br />� .. i..r' :. CR <br />Sewrr District <br />Monthly Sewer Service_ <br />Monthly Sewer Constr. <br />Trunk <br />Lateral <br />Abutting Lot Line <br />N, 5, E, W <br />Approved By � ('C-I.J l. ; i n.. t r <br />CiIY Engineer <br />�SSUCd ey � ��L. L !.�l,r .�. �_� <br />inspection By� <br />yJ�� <br />Qatelnspected �i ' � � "' � 7 — —_ <br />• <br />;7` ' c , �..... <br />;� . � � � y o . <br />�: b 1 l, j.. <br />