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ICHART NO.� ' �� ' 29-y <br /> everett �.S f;-t � <br /> � � ,� � <br /> a-�� 91��1�� %� <br /> , <br /> City of Everett / � <br /> Sewer Application and Permit �`�, _� � <br /> No. 23137 DATE -- <br /> Service Address Utility Account No. <br /> � <br /> Permit Fee <br /> Billing Address _ <br /> Connection Chargels) <br /> City, State, 2ip <br /> Owner (Mortgagor) Total Fee. — <br /> Billing Name <br /> Connection By__ <br /> ; ,. � <br /> Signed <br /> Address c""Ort1ef <br /> � , <br /> �" <br /> Phone <br /> i <br /> DESCRIPTION: Seveer District__ _- <br /> Lot [31ock Mo ithly Sewer Service_ - <br /> Plat <br /> Unplatted Description' M�onthly Sewer Constr. <br /> Trunk <br /> Type Permit: <br /> Lateral — <br /> Remarks: f+butting Lot Line <br /> N, S, E, W ft. <br /> � <br /> � '' s J Fz <br /> �� Approved By_ <br /> City Engmeer <br /> Issued By � <br /> Inspection By `" --" x� � <br /> Date Inspected �-� l- , 7 <br /> SEE SKETCH ATTACHED Na� 2313T <br /> IN;PEC110N <br />