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� ; <br /> CHART N0. - �' ' � >-�_ � <br /> everett <br /> �% s % �J� <br /> /z - �' - ? `� <br /> City of Everett ��� <br /> Engineering & Community Services <br /> 5ewer Applicatian and Permit <br /> N0. � �� ,:� i. �_ DATE � �f il � <br /> � � _, � <br /> Service Address �.� :-� i ��- / '< < �J -r,--Utility Account fJo: � -�%� ` � ->%' ' "`� ' <br />� � .., '�'-� �I <br /> Billing Address -� /�^ rr ✓ Permit Fee_ J%' ' <br /> ���� r �;�� � ��- <br /> ��-- <br /> City, State, Zip - _ -' � ' Connection Charge(s) ^ ^ � <br /> =. ;:_�, <br /> Owner (Mortgagor) .` : =! '' � �� � `, -�� � Total ;ee -� `� <br /> Billing Name ��- <br /> Connection By - ' <br /> Address Signed I <br />� � Cusromer . <br /> j Phone_ �� -`-•'_ /� '�/f,,. _ <br />', DESCRIPTION: Sewer District -� �`-� Y", � .�/-�- <br /> ., - � <br /> j Lot '- Block ! - <br /> Plat '-'z' � - i: _� Monthly Sewer Service=_'% r> � <br /> Unplatted Description � Monthly Sewer Constr. ', <br /> -: - ._- � <br /> Type Permit: ,, ��.., :� ' Trunk :, . . . ., �,, ,: <br /> /. <br /> Lateral <br /> Remarks: <br /> Abutting Lot Line � <br /> _ N, 5, E, W ft. <br /> _- � . <br />, Approved By '% � <br /> Ciry En§inaor � <br /> i r <br /> Issued By=� -- /�. <br /> � <br /> Inspection By _ � -�`-� _ <br /> _ Date Inspected�l d -� 7- 7��1 <br />' a <br /> SEE SKETCH ATTACHED N0. <br />` ��.��� _ � � 'I : .,. , <br /> ; , , ;. ,. :::, <br />` \,... : .::,., �x`'�', +�_ .--� � .,, , , _� .. ,:. . ,. <br /> f <br />