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. - C�RTNO. � -C� c' `— � <br /> everett � <br /> � ; ��-���"�/ - <br /> e . <br /> City of Everett � zc �---L� �/ <br /> Engineering & Community Services � ,9 <br /> ���7 <br /> Sewer Application and Permit }-�- <br /> , <br /> . <br /> � � . . ... <br /> N0. � � �i � �� DATE i/ r ���' _ � =. <br /> F.i. <br /> , •.,:� <br /> Service Address '� <- � �f/ ,-� ," ^'-" • Utility Account No. <br /> Billing Address Permit Fee `—�— <br /> City,State, Zip Connection (:harge�s)___ <br /> Owner (Mortgagor) Total Fee --- <br /> Billing iVame <br /> • .�.= <br /> Connection By ' �` ' � — <br /> .y�-..- %' G . <br /> .Address l l _ Signed� —��:�r 1!/ ' - � <br /> �.� � Customer <br /> Phone — <br /> DESCRIPTION: Sewer District_ , <br /> Lot � Block � <br /> Monthly Sewer Service j <br /> Plat � <br /> Unplatted Description Monthly Sewer Constr. <br /> Trunk <br /> Type Permit: .y- <br /> Lateral � <br /> Remarks: <br /> �— Abutting Lo� Line <br /> :/.J_C/..nr i ��„�,�tc .r¢ci� r_ �.� �'����.oaf N, S, E, W — ft � <br /> ! N�s i rt�� fi i—+—. rf 7 C I f U. !���JI• I7. c..r� I <br /> r � ¢ • � <br /> �, �ir!A r . cJ �].I <br /> j � <br /> Approved By �/` ' I <br /> Gry�Engineer � - <br /> � � i <br /> 1 I <br /> Issued f3y ' � <br /> I <br /> . ._� � <br /> Inspection By "'�� � ���%J'�;�::�� �' <br /> Date Inspected <br /> 'i/�1r��� � <br /> e � <br /> SEESKETCH ATTACHED N�• j <br /> i��, .�, ' , <br /> h , } ,. <br /> , .� <br /> `��.� i�- ... ,,� .: � , �: ,: .:. � : ° �� -�;�E:�Uc-•-.,: . ,. � <br /> .� . , . .., . , . . ... . . <br /> < .K_ , . .. > . . <br />