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=yCre11 f ., �i ,✓ � "� <br /> e 9� � . <br /> . <br /> Ciry of Everett <br /> Engincerinp Department � , . <br /> Sewer Application �nd Permit <br /> N0. DATE <br /> �ervice Address_ Utility Account fJo._______ <br /> Billing Address <br /> Connection Permit F�e <br /> City,State, 2ip <br /> _ Connection Fee <br /> Owner (Mortgagor�__ Iotal Fee ' <br /> Billing Name <br /> Connection By <br /> Address Signed <br /> PhOf1L' Customer <br /> DESCRIPTION: <br /> Sewer District__ <br /> Lo[ -- <br /> Block _ Monthly Sewer Service <br /> Division or Addiron Monthly Sewer Cunstr. <br /> Type Permit: Trunk <br /> —._ Lateral <br /> Remarks. <br /> � �-- Abutting Lot Line <br /> � 'ti, S, E, W ft. <br /> _ __ Approved By <br /> — City Enpinaer — <br /> _ Issued By <br /> -- ____ Inspec[inn By_ _ <br /> o -- --------- Date Inspected <br /> SEE SKCTCH AT'TACHED NO <br />