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^��t p,. �, t a,: ,.�'• : i. '2' <br />everett <br />� <br />City of Everett <br />Engineering & Community Services <br />Sewer Application and Permit <br />r,o. 22246 DATE 3 �� ��J <br />Service Address � 7 � "2 � � ' <br />BillingAddress ��' ' � ��l <br />C.IiY� $i3tB, ZIP - 7 �i r��a3lc <br />Owner (Mort�agor) � -�' '� ` � ` J <br />! <br />Billing Name '" ' ' �' <br />/ <br />Connection By '" <br />7Tr,P'- <br />CHART NO.���ss_ � <br />�I-, 3 �' - �`� - S <br />�%i' f ��-r � . <br />/ <br />Utility Account No. <br />J� �"� <br />Permit Fee <br />� <br />Connection Chargels) ' <br />U� <br />Total Fee � � <br />$19�ed �- Customer �I <br />% y % I <br />DESCRIPTION: <br />;.ot �i '�' � � Block � <br />r i /(,�,,_.%. <br />Plst c�' / <br />Un��latted Description <br />Sewer District <br />r <br />Monthly Sewer Service � <br />Monthly Sewer Constr. <br />SEE SKETCH ATTACHED <br />INSPECTION <br />itting Lot Line - , � �� • / <br />Nsew ,�I--�: <br />_�� ,1�. : . <br />�roved By�, ' �'- <br />City En9��eer <br />,. �: - : <br />ed By `=, �.�.- ..�- <br />�ection By , ''�!�- <br />e Insper.ted�� d 7 � <br />rvo. 2�246 <br />