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evereZt CHART N0. _ <br /> � � <br /> ��' ��'� <br /> City of Everett / ��� <br /> Sewer Application and Permit ��� <br /> No. 23437 GATE � I ; "� <br /> Service Address �� ;' — Utility Account No. <br /> Billing Address " r � ' Permit Fee • - <br /> City, State, Zip� � , ' Connection Charge(s) _ , <br /> Owner (Mortgagor) I � - Total Fee ` <br /> Billing Name � � - <br /> Connection By <br /> Address ' < i Signed <br /> Customer <br /> Phone ' " "� ' <br /> DFSCRIPTION: Sewer Gistrict '� <br /> Lot� �� � � Block ' ! <br /> ��ai _ , _ Monthly Sewer Service � <br /> Unp� ' Description Monthly Sewer Constr. d <br /> Type Permit: -- Trunk � <br /> Lateral <br /> Remarks: <br /> Abutting Lot Line <br /> N, S, E, W ft. <br /> Approved By " ' ` ' <br /> Ci�y Engincer <br /> Issued By ` <br /> Inspection By � <br /> i <br /> Date Inspected /— Z—�"G E <br /> SEE SKETCH ATTACHED No. 23437 <br /> INSPECiION <br />