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U <br />City of Everett <br />Engineering & Community Services <br />Sewer Application and Permit <br />rvo. 227gg DATE /'� � �� <br />,� , <br />Service Address �� `-� '" 1 ' . � !?, '�� <br />Billing Address <br />Ciiy�Sidte�Zip , ✓:`� �/! <�� /� w'/ <br />/ <br />Owner�Mortga9or) '�� � -+=. �� � �� _ <br />Billing Name <br />Connection By <br />Address _ <br />Utility Account No. <br />Permit Fee <br />C.nnection Charge( <br />Tot,:! Fee <br />�v <br />Signed �-'"� � �-1��-� <br />CUS[�t�Rf <br />DESCRIPTION: Sewer District � %%'' � �-� -.=- <br />Lot ;" ;� '> >- Block `� � � <br />Plat %�•1 � �� � ' ': ..y i:'-r< ( Monthly Sewer Service <br />Unplatted Description Mo�thly Sewer Constr. <br />Type Permit: <br />■ <br />SEE SKETCH ATTACHED <br />� wcir nua . i....n <br />INSPECTION <br />Trunk <br />Latera <br />Abutting Lot Line <br />N, S, E, W, <br />Appro�ed By � %�I: . ,,�.�.. ..� <br />Cily Enpinex <br />�% ' 7 � ' d f <br />Issued By ; . G �,��`.s,/'� <br />Inspection By <br />Date Inspected <br />� ' rvo. 22798 <br />— �� <br />M•�I . <br />'' w; <br />y F� <br />