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. _ __. <br /> �� _- - ��- <br /> CHART N0. C —'3�' Z�L'� <br /> everetl <br /> � ��� <br /> oc, 4���6�19 �d —L-S7� <br /> City of Everett <br /> Sewer Applicction cnd Permit <br /> No. 23135 DATE % � <br /> Service Address � Utility Account No. %„- __ <br /> Billing Address Permit Fee <br /> City, State, Zip Connection Charge�s) <br /> Owner (Mortgagor) . Total Fee <br /> Rilling Name <br /> � <br /> Connection By_ - j � / <br /> l� /� , . � <br /> Address Signed ��"'"?// ' � ` <br /> � ;Customer <br /> Phone i / , ; i. <br /> DESCRIPTION: Sewer District ' <br /> Lot Bloci: "� <br /> Plat _ Monthly Sewer Service <br /> Unplatted Description Monthly Sewer Constr. <br /> Trunh � <br /> Type Permit: <br /> Lateral " <br /> Remarks: <br /> - Abutting Lot Line <br /> N, S, E, W ft. <br /> Approved By - <br /> cuv E�a��c�r <br /> Issued By _ <br /> �o� �o Ca ��,� <br /> , <br /> Inspection By—�� �'-�--;� <br /> Date Inspected �' -�� - ?9 � <br /> i <br /> SEE SKETCH ATTACHED N�. 23135 <br /> INSPECTION <br />