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CHART NO. <br /> � everett I <br /> � � �c� ST�_ � <br /> (p— Z�t — gZ �i � <br /> City of Everett <br /> I <br /> � <br /> Sewer Application and Perrnit �� <br /> � <br /> . , {� � <br /> �� � <br /> � N0. 24305 DATE % � % �� ?S�'' I <br /> � � <br /> � � // ''� ��� � �5���•�: Utility Account No. <br /> Service Address � � <br /> � �/ � � <br /> Billing Address � � ' � � �� � ���• �6' Permit Fee � <br /> �l li <br /> � City, State, Zip /1�,t��C �a' ����" � •��� ���-- �' �.%�i Connection Charge�s) � <br /> .6�p,�v �� 2�f <br /> I� Owner (Mortgagor) �� � t >" Total Fee_ I <br /> I <br /> i - <br /> Billing Name j,�(, �'�'L'= " <br /> I <br /> � Connection By <br /> � <br /> I Siyned <br /> /�C�C�feSS_ Customer <br /> IPhone � <br /> i i <br /> � DESCRIPTION: Sewer District <br /> ., , . <br /> : <br /> ; Lot � ' � ' Block—>/ Monthly Sewer Service <br /> i Pla:�iO� <br /> �I Unplatted Description Monthly Sewer Constr. <br /> I Trunk <br /> � Type Pe it: <br /> � • Lateral <br /> Remarks: � Abutting Lot Line <br /> I . <br /> i ' N S E W ft. <br /> � / <br /> i � �,v � <br /> � ___y��p � � <br /> • <br /> � � � Approved By �L�-�' � <br /> � , /) Cily Engmecr I <br /> I ; ;�-�'" P <br /> ' � r � Issued By � ��� � <br /> , d, � <br /> /,' -.r ' � <br /> j Inspe�tion By -- � <br /> � Date I nspected_ — ' <br /> � SEE SKETCH ATTACHED N0. 2G3V`� I <br /> I <br /> � �� ,!'ll._I :, .� � <br /> _` ' —_.�— ..— __ <br />