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I <br /> I CHART N0. �� i�' ''-�'' -y <br /> everetl <br /> e ��'>sT�p _ , <br /> 3 zs S � <br /> City of Everett j � <br /> Sewer A lication and Permit � � <br /> pp I <br /> � <br /> NO. Z38OO DATE ����`�_ — I <br /> � <br /> i <br /> Service Address����� Utility Account No. � ' <br /> � `, I <br /> Billinp Address Q � • "i1`"J Permir Fee <br /> City, State, Tj c �� y��/9 Connection Chargels) <br /> � � <br /> Owner (Mortgagor � �'_Total Fee �� , <br /> Billing Name — <br /> Connection By ' <br /> Address Signed — � <br /> cu:lomer I <br /> Phone ��> '�_�L=1._l3f <br /> DESCRIPTION: Se•acr Disvict _ <br /> Lot� Block— (1 __ <br /> PI2��— � �L�, / Monthly Sewer Service_—_— <br /> i Unplatted Des ription -- _ �✓onihly Sewer Constr. <br /> Trunk _ _ <br /> Type Permit �� � ---- - - — <br /> // � Latcral <br /> —- �� ��� <br /> Remarks: <br /> Abuttiny Lot Line <br /> — N, S, E, W__ _— ft. � <br /> -----�— — <br /> — � — Approved BY_,C� ' _�� � <br /> CiI/Y nginccr % . <br /> -- -- �• <br /> / Issued By — ' <br /> � � / <br /> i <br /> Inspection By—� �'`� � <br /> —--- ----,---— -- ----- Datelnspected�F�=_�� �, <br /> SEE SKETCH ATTACFIED NO. Z3S°JO � <br /> i <br /> INSPFCTIO�: � I <br /> I <br />� • <br />