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�- CHART N0. w 1WqP-i <br />everett /, <br />O! <br />,e <br />City of Everett <br />Engineering & Community Services <br />Sewer Application and Permit <br />NO. -. 1.,1,['3 DATE <br />Service Address <br />(`' L I t t h" J• "" <br />Billing Address ` �' ` ..f cc ' ' t ITV k. )J E_- <br />City, State, Zip ("`t • ` "tt-L L7c..- <br />Owner (Mortgagor) ) (--" — <br />Billing Name %_ - T C t) <br />Connection By k T La <br />Address ( L. Z'I tr <br />/-- -? Y- 17L <br />Utility Account No. ' ( - (' <br />C' U <br />Permit <br />Connection Charge(s) <br />Total Fee <br />Signe/ <br />ustomer <br />Phone <br />Sewer District <br />DESCRIPTION: <br />Lot Block Monthly Sewer Service !Ik- 1 t—k Li <br />Plat <br />Unplatted Description Monthly Sewer Constr. <br />Trunk <br />SEE SKETCH ATTACHED <br />Lateral <br />Abutting Lot Line I L <br />N,(S,. E, W <br />APProvedBYt__ (Ll�wJt,��\aL4 <br />City Engmrer <br />Issued By <br />Inspection By— -'0 A <br />Date Inspected_ C <br />NO. <br />