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J <br /> CHART N0. ' <br /> everett <br /> � <br /> ' v ; .� <br /> City of Everett � <br /> En�inecring & Community Services <br /> �ewrer �pplgcati�n and �ermit , <br /> rvo. 2 2 60 £3 DATE %�""_�___�'�"���� <br /> Service Address_LL� J � Utility Account No. <br /> _;,:/ <br /> Billing Address Permit Fee <br /> � <br /> __._.------ <br /> City, State, Zip Connection Charge�s) <br /> / . ' /' <br /> Owner (Mortgagor)�f`• 1 � Total Fee ' <br /> Billing Name <br /> Connection By r i <br /> � ;' „ <br /> Address _ Signed`= � ;�"�-`�� � <br /> Cusromer � <br /> i <br /> Phone__ { <br /> DESCRiPTION: �, Sewer District_ <br /> Lot �� Block— ' � <br /> ._� � •��� " Monthly Sewer Service _ , <br /> Plat <br /> Unp!atted Description_ -- Monthly Sewer Constr. <br /> , <br /> � Trunk ; <br /> Ty�e Permit: i <br /> --- ` � � � <br /> -- __ __-_--_..-_- Lateral <br /> i <br /> Re • ;: - �Q� /�ECiEuc_� i .uh'L Abu ting Lot Line � <br /> �E� c �`i/G. U N, S, F. W fc. <br /> __ ', <br /> A roved B '�/� " <br /> PP Y�--r=.- <br /> Crty Engineer <br /> i <br /> issued sv �" -=�� , <br />� <br /> � Inspection By - <br /> I <br /> ��---- ----- <br /> Date inspected__— , <br /> SEE SKETCH ATTACHED Nn. '� � � � g ? <br /> INSPECTION ; <br /> ��.'-:�.-r _:r.A,-u_.-_-='-�-- =- � <br /> �"' <br /> �� - - <br />