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' CHART N0. '- ' ' � <br /> everett '� ' <br /> �='�=.��-� <br /> � ;" ��� 7`-7 � = <br /> City of Everett , , { <br /> Ennineering & Community Services � , <br /> Sewer Application and Perrr.�it : ; <br /> , <br /> N0. ;_ � ; �� � DATE (:,�-�/li' i <br /> 1 i <br /> Service Address �`��' fi � J _- -7' '�"-�" � Utility Account No. ; <br /> i <br /> BillingAddress�^� /'J`� '��.�' /^ r'� ^'` ' '� ' PermitFee '�0�" >—�-- � <br /> City, State, Zip!!'�"���*,-�/���� • ��0 3-3 Connection Charge�s) ��—_ 1 <br /> I <br /> Owner (Mortgagor) ( -',`� '�j; f�i '�"� • Total Fee " ` 1 <br /> , � <br /> Billing Name � <br /> Connection By <br /> ( � '� �r—� <<. � <br /> �f � / � i <br /> Address Signed�.�l-/ - - � <br /> Customcrj �' <br /> Phcne � <br /> I <br /> DESCRIPTION: SewerDistrict �y 1 � �1- ' <br /> Lot � Block-'J. `-` _ - � <br /> Plat !_-c--- �-a-'� ';.:G,�L�-/ Monthly Sewer Service ' I <br /> Unplatted Description _Monthly Sewer Constr. a <br /> � <br /> � Trunk -�• 7 - <br /> Type Permit: ;%/_,,,,,- i `;.�„ _, /-,_' ,j ' <br /> Lateral � � 3 + <br /> Remarks: �1� Cfi?�c . v'-- �� ri. <<C I <br /> �,� Abutting Lot.-Llne j <br /> -c�'�� `c-U � /�' �f'-i� (S�S. �: d- // �GU, c N, S,"E;`W �" `� ft. ' <br /> � il l, /-/. ��.� -e�/�.L�- � <br /> i <br /> i <br /> , � <br /> i/ � <br /> Approved By�� �f 'l � <br /> CiryEngineer ./ �� <br /> Issued By r . =� . (: i <br /> Inspection By - � ' <br /> Date Inspected <br /> 0 <br /> SEESKETCH ATTACHED NO. <br /> � <br /> i <br />