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-- - . . , •� <br /> CHART N0. <br /> e�erett <br /> e <br /> Cir{ of Everett <br /> Sewer Application and Permit <br /> ►vo. 25298 DATE � � <br /> Service Address 1(l ��G7mr��UEUtility Account No. � <br /> Billing Address Permit Fee �/�� — <br /> City,State, Zip Connection Chargels)— <br /> ^ � �� �J H M <br /> pwner (Mortgagor)� �k� V �$7CJ� Total Fee�.o � , <br /> � � <br /> Billing Name � <br /> Connection By����' � � <br /> Address Signed �: a�:�om�� � <br /> Phone�/J�ca�i � �v' � � z <br /> DESCRIP ION: <br /> Sewer District � v� <br /> Lot Block Monthly Sewer Service �j � <br /> Plat H <br /> Unplatted Description Monthly Sewer Constr. E� y <br /> Trunk � <br /> Type Permit: <br /> Lateral . � <br /> Remarks: 3 � ` GO K L- Abutting Lot Line <br /> N, S, E, W ft. � <br /> �, � � <br /> I � <br /> � <br /> � 1 f N 5 d w 1Ze <br /> Approved By � <br /> CitV Engineer Hn <br /> L�7 <br /> — v` Issued BY ` <br /> Inspection R� � (�!%�P//�^�— <br /> Date Inspected �� "��—� <br /> SEE SKETCH ATTACHED No. 25298 <br /> INSPECTION <br /> ' <br /> � <br />