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-•� - i � �� �.• <br /> CHART N0. <br /> evereft <br /> e � <br /> City of Everett <br /> ; Sewer Application and Permit <br /> ' DATE `/�'.� � ' <br /> ' No. 23027 <br /> Service Address '% � �� / Utility Account No. <br /> _ , �_ <br /> Billing Address— � �� � ' Permit Fee �-� <br /> City, State, Zip Connecticn Charge�s) <br /> ;,:r <br /> Owner (Mortgagor) � � — Total Fee ' <br /> Billing Name � <br /> Connec.ion By � , ' = �` <br /> r - <br /> Address 5�911ed c�s�omer �• <br /> Phone '/ � ,t, _ / • / j , <br /> DESCRIPTION: Sewer District <br /> Lot Black—. Monthly Sewer Service <br /> Plat <br /> Unplatted Description i � Monthly Sewer Consir. <br /> — `� Trunk <br /> Type Permit: <br /> �: Lateral <br /> / <br /> Remarks: _ Abutting Lot Line <br /> N, S, E, W ft. <br /> . , i <br /> Approved By /� <br /> crtv e�Oiocm , <br /> Issued By � -- <br /> Inspection By <br /> Date Inspected <br /> SEE SKEl�CH ATTACHED N�• Z3�T <br /> INSPECTION <br />