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1 <br /> CHART NO U r� � 24 4 i <br /> �; everett �o s �"'�-�'G' C'r'> ' <br /> � e � <br /> � <br /> � City of Everett <br /> � <br /> i <br /> i Engineeripg.& Community Services <br /> Se�►•.er i4pp�ication and Permi� ' <br /> , <br /> � � �� �-� � 4- -L� �� ` <br /> N0. � l ( .3 � DATE <br /> i <br /> Service Addres4�-I � C� �- ��- �-� �.��it_� . ��J Utility Account No. `'� �4� � � � � � _ U � � <br /> Billing Address�"��� �� � '��`" � f,`"'!" � V Permit Fee_ �'�L� ��� ' <br /> ��'t=t�-��r l C/r� %S ��%.� .G�u, oU i?cQ . Q u � <br /> City, State, Zi � Connection Charge�s) '� � 7 <br /> Owner (Moitgagor���"•' ������fsT�ti' �� Total Fee �'�" �^�'' � <br /> 1 <br /> l�illing Name ��'�""�-- � <br /> �l�_� F�I L_ �u'_��_ �.._� / .%':� � <br /> Connection B�-^ ��/ � . /'� <br /> / � � t`�;'�:./. /" ✓ <br /> l�ddfB55�<� L) � �71471-t �� � �J 9 ��' !!-.�=n,� % = `; i'.! ' <br /> Si ne r'C L . . / v.-sh-''•a } <br /> Cu�mer I <br /> Phone�%.- -_.� �_;:-� �. p -7 4 `^� _ <br /> DESCRIPTION: Sewer District �-� ��_'�-'��� � I <br /> Lat �- �� Biock �L .�.�� j <br /> Plat�=-7�� r�l,-'�'�i1^ �- :�7�-(�-- - P4onthlySewerService � <br /> - -� i <br /> Unplatted Description_ Monthly Sewer Constr. <br /> Trunk � ' � �`� <br /> Type Permit. � �� <br /> ��l.l..� �'t..�.\.�L.v �i �nJ <br /> Lateral <br /> Remarks: <br /> T , Abutting Lot Line <br /> '7�p ,���� �_ N, S, E, W_ ft. <br /> � rss ��-��_ '. <br /> � � � i. <br /> ,.Q,.r .c,...-.X""".�c.e2�. . — Approved By L . �-IE7-�iU � A.z�-� i <br /> � <br /> �� — 6 � y 7 �O Ciry Engineer <br /> Issued By � - �/,C'['r' i f 1�`+, �. <br /> � <br /> - -^ f <br /> 4 Inspection By <br /> �. -------- <br /> �� — Date Inspected____�_ <br /> .- 9 - - ='��--�-- — k <br /> � SEE SKETCH ATTACHEU \� NO. , • •`% � <br /> !�;SPcC1lC���' �� <br /> � � <br /> i <br /> +��. <br />