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� —_ � <br /> ; <br /> � cHaRr r�o. --�/t�� 2-t� —�l i <br /> everett � <br /> � -/---% � <br /> j-c'�5;� �-` � <br /> City of Everett r� TC� � / � • <br /> Engineering & Community Services Q� � � <br /> f`�� <br /> Sewer �4pplication and Perrnit : <br /> , ; <br /> � <br /> , <br /> _ , <br /> NO. �' _�' �_I ;�' DATE � � � — <br /> i <br /> Service Address - �r / .' Utility Account No. = ' ' ' � - � I <br /> �b 1 <br /> Billing Address -' �'^ ' Permit Fee � � __ � <br /> City, State, Zip � � .��—Connection Charge(s) � � <br /> �. <br /> Owner (Mortgagor) Total Fee � <br />� Billing Name � <br /> Connection By _ <br />' Address Signed _ <br /> I <br /> Customcr <br /> Phone %� � " / <br /> DESCRIP?ION: Sewer District �—=—�� � <br /> Lot - Block � <br /> Plat — Monthly Sewer Service � <br /> i � <br /> Unplatted Description ` Aqonthly Sewer Constr. � <br /> , . � <br />� Type Permit: ' � = ' Trunk _ . <br /> Lateral � <br />, ' <br /> Remarks: ; <br /> Abutting Lot Line j <br /> N, 5, E, W ft. � <br /> , � <br /> i <br /> � <br />, • i <br /> Approvr:d By_ - ! <br />, C�ry Engineer � <br /> Issued By ' _� � <br /> � <br /> I <br /> _ ,. � <br /> , ., i <br /> C. � { <br /> Inspection B� � ; <br /> i <br /> a IDatelnspected �—c�',� { <br /> i <br /> SEE SKETCH ATTACHE�7 N0. '. _; ,� j <br /> Ii:Sf-CCTIOfd <br /> ! <br /> � <br /> 7�t nr�s� i�r . ' <br /> I �' <br />� � . <br />