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A <br />everett <br />� <br />City of Everett <br />Engineering & Community Services <br />Sewer Application and �'�rmit <br />� _ �� <br />NO. .' ! ; _. �� DATE '- � <br />Service Address � � '� •`• � <br />Billing Address `' •,'' � �'/ ! , , V,:i � �, , ) <br />City, State, Zip � '� <br />Owner (Mortgagor) r .`�'� - ( :'�'�. ! J� <br />Billing Name �`'°"' <' <br />Connection By '� < �:- <br />Address <br />:�- Y�- S� <br />Phone - <br />DESCRIPTION: L-_ ��� <br />Lot�'�'� Block � Z' <br />Plat `- %: , -� / ,_ _i �/d (',� �1 /""� <br />Unplatted Description _ <br />CHART N � � � <br />��3 T�Cr� <br />2 - 3 - 7 c�' <br />�`� <br />Utility Account No. -'� ` - "` � <br />;! � U� <br />Permit Fee __ <br />Connection <br />Total <br />,i ir' /% <br />;� t � <br />Signed_ � <br />Customer � <br />SEE SKETCH ATTACHED <br />�If'''�!'� �-;Ilnf� <br />� <br />� �. � Y!. �.i'::8� . ' '.'�I d��''-}��i w� 5 . .... _ . .. .. .. <br />SewerDistrict �1'-��'� /` ''�� <br />Monthly Sewer Service �'' = ^� <br />Monthly Sewer Constr. <br />Trunk <br />Lateral_ <br />Abutting Lot Line <br />N, S, E, W_ <br />Approved By ��� `% ' <br />c�iv e������� �•� <br />Issued Bv - �� , � _� �- � --- -- <br />� <br />Inspection By ` _� _- ��� _✓. _ <br />Date Inspected ��.�/�� <br />/ ' <br />N0. <br />� � - � <br />�3". -, . . .�. _�o . - 'rra . �.� �`i <br />