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_�. - <br /> �� CHART NO.fI'" `� '��`�� <br /> everett , <br /> i � 1�'� �L � <br /> � <br /> � City of Everett /I y��/ _ �y <br /> I Engineering & Community Services V _ V <br /> � Sewer Application and Perrnit �f�' � I � <br /> � . - <br /> , <br /> � NO. - .'� � , , :� DATE !//•- � %'/ — -- <br /> I <br /> � ServiceAddress � SQ � i= '•-�-. ,� UtilityAccountNo._� � � � >/- � c� <br /> I _ <br /> � Billing Address --���. . 'i,f �//� Permit Fee >" � <br /> i ., <br /> � City, State, Zip_ ��--,-�%f'�. .-,/ �/,� . /r�Q,i� Connection Charge(s) �' ; �� ` <br /> Owner IMortgagorl�� � �'� ;:•.r'% - ,_ Total Fee � <� � <br /> � <br /> � Billiny Narne _ �� � <br /> � �� <br /> Connection By _ c._ � <br /> � Address I <br /> � Siyned <br /> Iv Cusiomer <br /> � Phone_ 0 -���- ��' ��%� <br /> t <br /> I DESCRIPTION: Sewer District J" :i %-'� _ / � <br /> � Lot �.1 �ock <br /> .. . • :,: -�1• 50 ' <br /> Plat�t:�_�'c: .< - (-- ..-/: -� Monthly Sewer Service <br /> �i <br /> Unplatted Description _Mnnthly Sewer Constr. � <br /> � Type Permit ' �� — Trunk -Y • ;' :' <br /> � - � .�. �: <br /> � Lateral <br /> f Remarks: <br /> IAbutting Lot Line <br /> � N, S, E, W ft. <br /> � - <br /> i <br /> i <br /> i , <br /> iApproved By � r'_1/-,: . <br /> � Gry Enqmeer <br /> j <br /> � ,,� �� . <br /> ; ISSUed By " _ -- ' <br /> i <br /> � <br /> � — <br /> � � <br /> � <br /> ' _ Inspection By � ����Q�� <br /> —._ , <br /> i9 ��� Date I nspected_ %l/�7���?7 <br /> I SEE SKETCH ATTACHE %� N0. �' _ <br /> i I1;Sf'FC1�It���; <br /> � =�a 3 _ r <br /> :A1�1'�� m..� . _=..�'' t.. <br /> ,�T. � <br /> ___ -- _ _ . _. — —:si:Y__ . _— _ __—. _ _ . � <br />