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0 <br />f <br />City of Everett <br />Engineering Department <br />2/� <br />Sewer o�a!acu;;v.. a permit <br />NO. '404b <br />Service Address <br />/) Utility Account No. <br />Billing Address <br />City, State, Zip = T <br />Owner (Mortgagor)_ <br />Billing Name <br />DATE <br />Connection By <br />Address <br />Phone <br />DESCRIPTION: <br />Lot <br />Block__ <br />Division or Addition <br />Remarks: <br />in <br />SEE SKETCH ATTACHED <br />Connection Permit Fee — <br />Connection Fee_ <br />Total Fee ram" <br />Signed <br />INSPECTION <br />Sewer District <br />Monthly Sewer Service <br />Monthly Sewer Constr" <br />APProved By .- / :."t/'e) <br />City Engineer <br />Issued By <br />Connection <br />Inspection By—A <br />)ate Inspected_ yZ± 117 <br />