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� ' CHART N0. `1 � � � � �� `f <br /> � everett , <br /> . � , . <br /> ! _.. <br /> � C�ty uf Everett <br /> i Engineering & Community Services <br /> ' �ewer �►pplication and Permit � <br /> � <br /> � � � _ � <br /> � N0. '- - � �) / DATE `��7�7 . <br /> i , // <br /> f Ser�ice Address - -% Y � ! �-�° �� � ��l � <br /> � �f � f� ��/.1r=.UL::(:•�' /�-,cEJtilit Account Na <br /> t t.,U <br /> � Billing Address%� /<! ' - !��-':.- �' �-- Permit Fee �::✓� <br /> E � � <br /> ,t r�Cl <br /> City, State, Zip �•�'L.�'£�I i�S c�� � Connection Charge�s)_�` `'F'�r'' l���.. ��/�7 <br /> ` ' �`^ — <br /> ' Owner (Mortgagor�� •'�iJ,:�L.-t�Cc /�r:���u Total Fee � n <br /> iBillingName � ��"�`��- _ -+ <br /> � �� � <br /> ! Cornection By -,��`t'�1�= _ __.. S <br /> �( �. �, -� � <br /> Address /C:/G `.� Jf�ii. ,4(�L �• �- Signed�.,n,�C. �i�C' ���/,� _�/ry�!!. <br /> us�omcr <br /> Phone =f>j 7' '. c C��.� <br /> DESCRIPTION: Sewer District �L� ��-�«%�-�•'�:� _��-�-�. I <br /> i Lot Block_ Monthly 5ewer Ser��ice �•���- j�� E-'� <br /> ( Plat_ <br /> � U n p l a t t e d Descri p tion � ��"t�� C`� C.l., � C: G Monthl y Sewer Constr. <br /> � <br /> C.�,=' l:_ '...�G j ` D r �-��7__ ��.- ��Q. �� �- Trunk ,�.. O c_� <br /> ' Type Permit: � "L-Z- k �� 4 <br /> � Lateral ">. � C.� <br /> � /UE��f1 �.C), t =r�.- i <br /> � Remarks: <br /> Abutting Lot Line /1 <br /> N,�.'E, W �G'�� _ft. <br /> ! <br /> � APProved By � 1�--t'�.f1.t 1/ti.� �� ' <br /> � , City Enyinccr <br /> i Issued By <�- ��.�:C�13/�'%Uv __ <br /> � <br /> I r, <br /> ( Insp��ction By— � ���:�-/----- <br /> � <br /> ; Dateln;pected S 7 .__ <br /> n � ; <br /> � SEE SKETCH ATTACHED N0. � • � <br /> � 'ECTlrr,d �,sq�:� -�, R , <br /> ,�i '�� <br /> � ���.* `��iG��� . «���.� ,_.. . . vre0' � ��� ,�..� �P %.. Y F" q4�. �� �� . <br /> � <br />