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evere'tt . - <br /> � -1 ^ � . � .... �, <br /> � l <br /> City of Everett <br /> Engineeri�p Department <br /> Sewer Applicatica and Permit <br /> � ti788 <br /> N0._,-� 2J�7 '� DATE <br /> Service Address `�' �' r '�" . :' '^ Uti t No. <br /> Billing Address '-' ' :: r i �iV % -% Connection Permit Fee 1�.%: � <br /> City,State, Zip ,� % i . ; '.v'! � � ' ' Connection Fee ' <br /> � <br /> Owner (Mortgagor) � � � ., Total Fee_ <br /> BillingName _�! ��Y,-%� <br /> Connectio� By - '/i/. ',� i ' ' i . % _ <br /> � � '/ <br /> Address— i , ��,�%L, � �> > 1 �._�C� , r'_I, - <br /> Signed � <br /> Phone— /i�-` c��ro�, <br /> DESCRIPTI ON: <br /> Lot� .: <br /> Block <br /> Division or Addition ti%. '- . , i ! . < /'i :.,--� <br /> Sewer District i- <br /> Remarks: � `. ; _ ���/ .; ,r� .nT , , MonthlySewerService - - <br /> Monthly Sewer Constr. - � <br /> .c '' Co-,�,.,, �- -- <br /> �_ _, . � , . �� �,�, , <br /> � <br /> Y���Q °�C ti/J �� --- APProved By <br /> � c Ciry Engmeer <br /> Issued By <br /> Connec[ion By <br /> Inspection By—.p "��-�-�.�> <br /> Date Inspected_ ��7 S�J) <br /> � <br /> SEE SKETCH ATTACHED <br /> �u�:urr-i i„�� <br />