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� <br /> CHART NO. <br /> everett I <br /> � ,' <br /> , j <br /> I <br /> i <br /> City of Everett �,` �'� � I <br /> :ti � <br /> �.. <br /> S�wer Application �and Perr�it � � `� �� <br /> I <br /> NC. G4758 DATE ��.--�— <br /> i <br /> I Service Address � � � � 3 7� �_�-� Utility Acccunt No._a — I <br /> Billing Address � - � Permit Fee � �~ I <br /> City, State, Zi � i Connection Chargels) �� <br /> � � �q�r�• .Z o� J �i <br /> Owner (Mortgagor)�' - �-"`�� <br /> Total f-ee� I <br /> � <br /> i <br />� Billing Name �I <br /> I � <br /> Connection By __ .— <br /> Address Signed � c�:�am�� � <br />� Phone_ �03 — d2 02� �� I <br />� DESCRIPTION: Sewer District � <br /> I� Let Blocl q Monthly Sewer Service �I <br /> Plat - <br /> Unpla ed Description Monthly Sewer Constr. �i <br /> Trunk II <br />� Type Permit: _ � <br /> Lateral j <br /> 4 Remarks: I� <br /> Abutting Lot Line <br />' N S E W ft. � <br />��I I o Pc��On � <br />� I JP//C�c� '� <br /> � - <br /> 7-3�-� qPProved By���..-���� <br /> /���/ Ciry Engmeer � <br /> •�✓ f � <br />� � ISSUE(J By___1rJ---'--�-�-�"-� �I <br />� I <br /> Inspection By <br /> Datelnspected — <br /> SEE SKETCH ATTACHED No. 24758 <br /> I INSP�C710h1 I <br /> J <br /> 1 , <br />