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J <br /> evecett CHART N0. �� �-Z � -� <br /> e �Ds;�a� <br /> � -� � . 9 <br /> City of Everett ^ �J <br /> �//� <br /> Sewer Application and Pecmit <br /> N0. 23ZO6 DATE ' <br /> Service Address , % /. _ Utility Account No. <br /> Billing Address Permit Fee � ' <br /> City, State, Zip Connection Charye�s) <br /> Owner (Mortgagor) ��� Total Fee J __ <br /> Billing Name <br /> Connection By � <br /> _ :, • <br /> Address y� � � <br /> Signed �`i <br /> - � � Customcr' <br /> Phone <br /> DESCRIPTION: Sewer District <br /> Lot Block � <br /> Plat_ - Monthly Sewer Service _ _ <br /> Unplatted Description Monthly Sewer Constr. <br /> Type Permit: �,.. Trunk <br /> Lateral <br /> Remarks: <br /> Abutting Lot Line <br /> N, S, E, W ft. <br /> �w6 �' t CoJ�,CED <br /> � <br /> — Approved By - <br /> Ciry Engineer <br /> Issued By % <br /> , <br /> Inspection By_ <br /> Date Inspected 7 " �� � 79 <br /> SEE SKETCH ATTACHED NO. Z3�V6 <br /> � INSPECTION <br /> � <br /> -+._ <br />