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CHART NO. <br /> eve�ett <br /> � .`.r „-t �- (/� , f� �� 5-�.'-g9 <br /> City oi Everett <br /> Sewer Applicction and Permit <br /> N0. Z��U� DATE Me���9B! — <br /> Service Address '+�6 B.+eti .... Utility Account No. <br /> Billing Address +--- Permit Fee . <br /> City,State, 2ip =.+.+tt, lta 9Y�03 Cunnection Chargels) <br /> Owner (Mortgagor) ��, �,��= Total Fee . <br /> Billing Name a.... <br /> Connection By --•�� �'----___. <br /> Address�427p�'..� Signed --'� <br /> --cu:tomer <br /> Phone � «^, <br /> DESCRIPTION: Sewer District <br /> Lot Block <br /> Plat Monthly Sewer Ser��f <br /> � <br /> Unplatted Description Monthly Sewer Constr�. �i� • <br /> Trunk R � �T•� <br /> Type Permit: o!t <br /> Lateral �R �'•�� <br /> Remarks: . <br /> Abutting Lot Line <br /> P N, S, E, W ft. <br /> i � <br /> Approved By �� 1_ �ta 'r�iL <br /> cicy Enpine.r <br /> IMPORTANTI Issued By so+y e�na.� <br /> CALL 1$OOd24•5555 48•HOURS <br /> PRIOR TO DIGGING <br /> CALL 2F9-8811 FOR INSPECTION <br /> Inspection By <br /> Date Inspected <br /> SEE SKETCH ATTACHED NO. L��O� <br /> If�JSPLCIION <br />