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CHARTNO. � ��—�� —s' <br /> everett <br /> e <br /> City of Everett <br /> � Sewer Application and Permit <br /> N0. Z3OZ7 rj�� � DA"fE _ , ' , �_ <br /> � L <br /> I / _ <br /> Service Address — ,c—�L�'l � Utility .4ccount No. <br /> Billing Address Permit Fee - <br /> City, State, Zip_ Connection Charge(s) <br /> Owner (Mortgagor) Total Fee I <br /> Billina Name <br /> Caniiection B�•.__ _ _ <br /> i � <br /> Address. Signed� <br /> '� Curiomer <br /> ��� <br /> Phone <br /> DESCRIPTION: 75�, Sewer District <br /> Lot_ Block <br /> Plat Monthly Sewer Service <br /> Unp!atted Description Monthly Sewer Constr. <br /> - � Trunk <br /> Type Permit: <br /> La[e�,:l <br /> Remarks: <br /> Abutting Lot Line <br /> N, S, E, W ft. <br /> �— — - <br /> e <br /> � /'�_, �, � �LV. _; J APProved By e <br /> City En mcer <br /> Issued By _ % <br /> Inspection By�� � <br /> _ IDate Inspected - <br /> SEE SKETCH ATTACHED N0. 'Z3(�27 <br /> iia�i'f_�?�!GI� <br />