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CHARTNO. L- �' ' Z`�- � I <br /> everett i <br /> � i <br /> /�o��'��- � <br /> � � - � � � <br /> �` �,-- - - �S 1 <br /> City of Everet2 /��;�./� I1 <br /> Engineering & Comrc�unity Services I <br /> Sewer Application and Permit <br /> � ,, , ; <br /> N0. I �_ ,. � � DATE � ' �i� � � � _ i <br /> �' / � -,� � <br /> Service Address -' �=' �7 � %� ' ' ' Utility Account No. <br /> � <br /> Billing Address Permit Fee " <br />� City, State, Zip Connec;ion Charge�s) - <br /> Owner (Mortgagor) Total Fee = -� <br /> Billing Name � <br /> Connection By � ''-f ' � I <br /> Address /�'� Signed I <br /> Customer <br /> Phone — <br />, DESCRIPTIOIV: Sewer District <br /> Lot Block <br /> Plat Monthly Sewer Service <br /> Unplatted Description Monthly Sewer Constr. <br /> i <br /> i <br /> Type Permit: � ,. Trunk <br /> � <br /> Lateral <br /> �-, �_ � <br /> Remarks: �'� - _ <br /> Abutting Lot Line <br /> N, S, E, W ft. <br /> — c?4��..LZ�ic, � �-1��eGc �x- /" •� .S JJ .�i , I <br /> �Gc�.. �- .��� � 5• � /7/� ht. .:-�<. �.2'" <br /> - `i <br /> Approved By- ' <br /> City nginrei <br /> i Issued By ' . __-`� � <br /> i <br /> 1 <br /> Inspection By �-e�-� �.� �>-"-�- / _ { <br /> Date Inspected -� ' 3� - 7 � � <br /> 0 <br /> SEE SKETCH ATTACHED N0. _ <br /> I!�':;P' ! il0i`!� �; <br /> F- " . �tFy�y �. + ^ <br /> �" sJbl�$' SFl�1.: .+.Fr,.'i.t Jr......� . ...... .. . . <br />