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� CHART N0. <br /> Ieverett <br /> e <br /> City of Everett <br /> I <br /> Sewer Ap�alication and Permit <br /> N0. ���a� DATE netot��s 34. lii7 <br /> Service Address Utility Account No. <br /> 8illing Address Permit Fee ia_eo <br /> City, State, Zip Connection Charge�s) <br /> . <br /> Owner (Mortgagor) �� t Total FPe lo.00 <br /> Billing Name <br /> Connection By <br /> Address Signed ' _ <br /> � Customer <br /> Phone <br /> L`ESCRIPTION: Sewer District <br /> Lot g� Block <br /> Plat Monthly Sewer Service <br /> Unplatted Description Monthly Sewer Constr. <br /> Trunk lU�tGiEi7 i::>UFY1 UOOltq7A1] lill <br /> Type Permit: <br /> Lateral ���'�7 <br /> Remarkr. ��U�J�Hr�4fs � <br /> Abutting Lot Line��lk ioU.t)D <br /> N, S, E, Wy��pn�z�il it. <br /> SF4piR T10.(10 <br /> — i1l�lli11i9SY <br /> r��a, yw.c�i <br /> GA:(:I; eiU'S.W <br /> Approved By <br /> Ci1Y nqmen i <br /> IMPORTANTI i <br /> Issued 8y 8usy Yiurpa <br /> CALL 1$OOd24•5665 48�HOURS <br /> PRIOR TO DIGGING <br /> CALL 269�811 FOR INSPECTION <br /> Inspection By <br /> Date Inspected <br /> SEE SKETCH ATTACHED No. 26381 <br /> I�JGPCC iION <br />