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� � � <br /> � � x <br /> � H <br /> � H � <br /> H � H <br /> � H � <br /> � H � CHART NO. <br /> VJ H <br /> z I everett � <br /> � y � = i <br /> H C+7 O e ;? �I <br /> �y � I <br /> y y z City of Everett _ _ - � �n�Tl�r I^�&'9 � <br /> ' � .� V <br /> rHy _ _ <br /> ti <br /> g�r ' Sewer Application and Permni� _. � _ � � <br /> � y � _ " _ �' � ,'_' '� <br /> Ho �n I Z15G� DATE i'. � _ . _= � � .. _ " <br /> N0. t %�rn�rv 1�� l9n(1 <br /> I Service Address � ` !� Utility Account No. � <br /> BillingAddress > >'+ �� "�' b�;-� ^� ��^8 PermitFee �� ��� <br /> � City, State, Zip ^°1 �^�' 1Cr `'��+ U5'j(1; Connection Chargels) crrs7u r � i � •tec'.�n � <br /> Ig2749:; I <br /> I Owner (Mortgagor) :ia l<�F-, ar,nc� f�- i + i �- Total Fee ;�� �'� i <br /> Billing Name �a� — II <br /> Cc+nnection By sasaFarcx n�.,-:,� �e��� i <br /> " Address S�M Signed <br /> ' Cusmmer I <br /> I <br /> � Phone r35� ` �-" � <br /> B ' DESCRIPTION: SewerUistrict �n ' rrT <br /> ��� i Lot_ Block — Monthly Sewer Service I <br /> '�' Plat I <br /> ' Unplatted Description _ Monthly Sewer Constr. �, <br /> '�� Trunk I <br /> v Type Permit: •�W ro•lt P - iun i <br /> ' Lateral <br /> �� Remarks: Abutting Lot Line I! <br /> �e N S E W ft. i <br /> ' �� <br /> �� � APProved By n�ti•.,,.� � ,,,-,���� II <br /> �' Ciry Engincer �� <br /> I I <br /> � IMPORTANT! ' <br /> ISSuOd By `'tt^yy '��n�+�n ! <br /> � CALL 1�800-424-5555 48-HOURS i <br /> i PRIOR TO DIGGING � <br /> i ) <br /> 'I CALL259�8811 FOR INSPECTION � /. <br /> ` <br /> I Inspection By - <br /> Date Inspected ��f/4/� �� <br /> ISEE SKETCH ATTACHED NO. ���U� I <br /> I I��!:':''C': i !Q rJ � <br /> i � <br />