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i <., . <br />i everett <br />�, � <br />� City of Everett <br />� Engineering & Community Services <br />Sev�er Application and Perrrait <br />CHART NO.T-7'-3��� <br />�o s ✓ `�-� <br />� <br />�� � � '' ' � DATE 1J _ /i. // I—_-- <br />NO. F_ L�• -., .. Y <br />; ��-� ��,�• <br />� —�- ' � Utility Account No. <br />� Service Address �" � � - <br />j _ � <br />! Billing Address ' ��� � � Permit Fee �'' <br />City, State, Zip � -��1 '� '� Connection Charge�s) <br />iJ <br />Owner (Mort9a�or) ' '� �/ �f _ Total Fee �'-'� f� <br />Billing Name " <br />Connection By — — �' � / <br />1 '!� � <br />Address _ Signed ' _ <- �- ` <br />Cusmmcr / <br />Phone � �' "� l — <br />DESCRIPTION: <br />Lot � <br />Plat ' <br />Unplatted Dcscription. <br />Block �� <br />Tvoe Permit: /� /, = �:(l <br />Sewer District <br />Monthly Sewer Service_ ' -� <br />Monthly Sewer Canstr. <br />Trunk _ <br />I_ateral ._ <br />Abutting Lot Line <br />N S E W _ft. <br />Approved By - ." - <br />c��v e�,B �c�r . <br />SEESKETCH ATTACHED <br />IWSPLClIOi�i <br />F�}".4�f��.� ., . . .� . <br />Issued <br />Inspection 8y_—J� C��h � <br />Datelnspected � � � <br />N0. <br />_ . . _f <br />