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! CHART NO.� <br /> I everetl — <br /> e . �__ - �-�� .�� _�;., <br /> � �:�� I <br /> � Y!}-� � - S'- � 4 i <br /> City of Everett , <br /> � <br /> Sewer Application a�d Permit � <br /> � <br /> N0. 2314��' DATE �� ��i � � -- � <br /> ; <br /> Service Address _ % Utility Account No. <br /> Billing Address Permit Fee `. i <br /> City, State, Zip ^ Connection Charge�•,) _ <br /> Owner (Mortgagor) Total Fee � <br /> — � <br /> Billing Name I <br /> IConnection By _ �_`__ �._ i <br /> Address Signed ' I r <br /> I CuStomer� i <br /> Phone i <br /> DESCRIPTION: Sewer District i <br /> Lot Block � <br /> Plat Munthly Sewer Service i <br /> Unplatted Description Monthly Sewer Constr. <br /> Type Permit: � � Trunk � <br /> :� <br /> Lateral j <br /> � � — — • . , I <br /> 4emarks: <br /> ��-. . , /�. .+r, �_ y�= ., /. ;( ,�,� � <br /> -Abuttin Lut Line <br /> ( ,� I' "^ ' '%� � < +`� '_{�, N, S, E, W f[. j <br /> I <br /> I <br /> 1 <br /> I <br /> Approved By <br /> I <br /> - _ Crty Engincer I <br /> Issued By I <br /> InspectionBy --:iI �'��� ; I� i <br /> Da[e Inspected /� � � <br /> i <br /> SEE SKETCH ATTAC�iED N�• Z'�I49 'i <br /> I <br /> R�I;f'[CTIOIJ � <br /> — � <br /> ;.;r.- � - � --. _ . _ -' <br />