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�v- .;' _�_� � <br /> CHART N0. <br /> everett � <br /> l�v S �' ��� ; <br /> � g� ` 1' <br /> City of Everett ` Z � � � i <br /> i <br /> Engineering & Community Services �/ � /� � <br /> /irie-� I <br /> 5ewer Application carod Pe�mit ; <br /> , <br /> ,�, - i�-� - i;-;� � <br /> NO. �' J i'; � DATE — � <br /> -- i <br /> 7: - i <br /> Service Address �j-� �`G' � '� Utility Account No. , <br /> i <br /> Billiny Address Permit Fee '� <br /> � <br /> City, State, Zip Connection Charge�s) <br /> Owner (Mortgagor) Total Fee_ � <br /> � <br /> Billing Name I� <br /> � >� • , / �� <br /> Connection By �--" � <br /> i <br /> Address � Signed_` ' ~ i <br /> �� CustomerV � <br /> Phone I <br /> DESCRIPTION: Sewer District � <br /> Lot _— Elock I Monthly Sewer Service ' <br /> Plat <br /> Unplatted DescriptlQn Monthly Sewer Constr. i <br /> , <br /> Trunk ; <br /> v � <br /> Type Permit: " , , <br /> I � Lateral _ ,' <br /> Remarks: Abutting Lot Line i <br /> ..� -t,�,�- � �� S. $ , ,ti„_.. � .:�.- f N, S, E, 6'V— it. <br /> 1 <br /> ��-FL. . c.. ISl CG ID ID � ([ <br /> �� ' l' � G ' � , /� � ��Cc . I <br /> _ic,f ,/� � . APProved By` ,, ,% <br /> City Engmeer �� <br /> ISSU2�j BY _.�'_� �I <br /> 1// <br /> l��y��� ���' �. <br /> — Inspection By '/ <br /> Date I nspected_��!<•/� X <br /> a — <br /> SEE SKETCH ATTACHED N�• ` <br /> �I <br /> � <br /> -�,.-., __ . <br /> � , <br /> ��-� .:i:. ti& +a �, " . � ' �s - �' "'� - �•__.., — _ . '. � <br /> ��.� _ ... . , . . . . . <br /> i <br /> ..:.. � - - _ - <br /> ' <br />