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�a ` . <br /> evereH -� ,. � <br /> U " � <br /> e _ � , . � � z � ,�� � <br /> 6 - � � ` , <br /> , �,, ., ��U,,� <br /> City of Everett <br /> Enpineerinp Department <br /> Sewer Application and Permit 3 .; , �„ <br /> No. 20624 DATE <br /> is�� 3 ��, � �--,t , <br /> Service Address Utiliry Account No. <br /> Billing Address Connection Permit Fee <br /> City, State, Zip r" � , � Connection Fee <br /> Owner (Mortgagor) /� '`� � Total Fee <br /> Billing Name <br /> 1 <br /> Connection By /�•�Cl/�'O��JG i; �/,�f � ,_ ,`: . C : , ir ) r. , <br /> Address_ Signed� •�_ �-• ' <br /> \ Cultortnr ^ <br /> Phone_.. <br /> DESCRIPTIO�V: Sewer District_ — — <br /> Lot Monthly Sewer Service <br /> Block <br /> Division or Addition Monthly Sewer Constr. <br /> Trunk <br /> Type Permit: <br /> Lateral <br /> Remarks: Abutting Lot Line <br /> N S E� Vy ft. <br /> Approved By_ ' <br /> Ciry Enginen <br /> Issued By <br /> — Inspection By � � lA�," J — <br /> Datelnspected � � � <br /> e SEE SKETCH ATTACHED N�• � Q G 7 4 <br /> i , ,� � � nr: <br />