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i I <br /> f everett CHART NO���o �Z�j� � <br /> � � , �O S G_•L`�Ps� <br /> ( / '- /3- � S` <br /> � City of Everett <br /> ; Engincering & Community Services �ljalr. <br /> �' Sevver Applicati�n and Perr�at <br /> � <br /> � <br /> , NO: ;� � �i �J � JATE //�IS�77 � <br /> IService Address ���y �G� jl ��, - Utility Account No. <br /> I f/ <br /> i Billing Address ��� Permit Fee �' <br /> City, State, Zip�s-r c� _ �� �_/_/�.� Qs�d� Com�ec.ion Charge(s) <br /> ' Owner (Mortgagor) _ Total Fee � <br /> � -- <br /> i Biiling Name <br /> i <br /> � u - d <br /> � Connection By , . ,�� <br /> � Address_ � �" / <br /> i Signed �-= c.�-./ `1,��^-.:t.�-� J <br /> �� � _ _, . , Cirmmer <br /> �� Phone_ -;.' .S f— �" %�5'S � � <br /> i <br /> j DESCRIPTION: Seive• District <br /> � Lot ?� `� -3 � Block � � <br /> � Plat_�-,<�.--r�-t .,G �� Monthly Sevver Service_ <br /> � <br /> � Unplatted Descripti' n_ � Monthly Sewer Constr. <br /> � <br /> � Type Permit: - ' Trunk _ <br /> / Lateral <br /> Remarks: <br />� Abutting Lot Line <br /> � N, S, E, W ft. <br /> � � . � ,�. . <br /> � � ''� ,�, .��, <br />' APProved By_ I - /' : , <br /> � Ciry Enginccr <br /> / <br /> I � � <br /> Issued By/''% - ��� <br /> � � r��' - <br /> II <br />' Inspection f3y_ ' ��. <br /> �t..�i .,�.1--.4-a.�.�---�J�' <br /> � Date Inspected <br /> SEE SKETCH ATTACHED r� � No° ' �:� <br /> � i�;=�'�_Ci��t,`� � <br />, f , � _ -- - <br /> � i��,, . , "��^ � ` �ras�- ��.�,� <br /> -`�__-,. <br />� <br />,. -.�.a-_ --- _ �_ _ ___ _ — <br />