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� �. <br /> j CHART N0. x ��"Zl�—y <br /> j �� ��� <br /> � �����,�(���� s <br /> City of Everett /e1�— <br /> SeHver Ap���ic�tion and Permit <br /> N0. ZZ0�.7 DATE � ' � � " % / -- <br /> Service Address � /' "� _ � ' � Utility Account No. / — <br /> ..--- .�-- <br /> � Permit Fee � � <br /> Billing Address � � —' <br /> � � =� � <br /> :� /; <br /> City, State, Zip Connection Charge(s) <br /> _ _ � : , --� <br /> Owner (Mortgagor) i Total Fee ' <br /> Billing Name f <br /> Connection By % > � <br /> ,,. :, ,-J,;-=� <br /> Address ianed , <br /> Cusmmer <br /> � . _' <br /> Phone � i <br /> i �� <br /> DESCRIPTION: Sewer District ' <br /> � i � <br /> Lot � ' Block - • - � <br /> r�---- Monthly Sewer Service <br /> Plat �' <br /> Unplatted Description Monthly Sewer Constr. ' <br /> __ Trunk /- ! = � <br /> Type Permit: <br /> Lateral <br /> Remarks: Abutting Lot Line <br /> N, S, E, W ft. <br /> .,_r�,�- � ��� <br /> ` Approved By <br /> . �_- � City Engineer <br /> � ',' :. ,. , /� <br /> . Issued By — — <br /> I <br /> I � ,�.•.., I <br /> �- � � � �� <br /> , Inspecdu� By �"' °'"� i <br /> -- � <br /> i Date I nspected S " 3 — 7 � I <br /> SEE SKETCH ATTACHED N�' ZG839 I <br /> I <br /> INSPEC110N � <br />