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::, <br /> _ '- - ��'` <br /> everett — ^`' <br /> I � ; , _ <br /> � � � � � ,� —' � � <br /> ; <br /> , <br /> ' y ���� �.t <br /> f <br /> i <br /> � l �-?�/_ I � «-: � <br /> , ,�r � �,r� _� <br /> City of Everett �`' '' „ <br /> Engineering Oepartment � <br /> Sewer ,Application and Permit <br /> 32395 <br /> rvo. 10 0 5 9 / DATE �� <br /> is�� �3,eo2d�. ��y <br /> Service Address Utility Account No. <br /> Billing Address_ Connection Permit Fee <br /> City,State, Zip Connection Fee t <br /> Owner (Mortgagor) Total Fee <br /> Billing Name <br /> Connection By <br /> , . <br /> \ �v,� , '` <br /> Address Signed �- � �- 'ti- �-� 4. <br /> Customer '� <br /> Phone <br /> DESCRIPTION: <br /> Lot <br /> Block <br /> Division or Addition <br /> Sewer District <br /> Monthly Sewer Service <br /> R emar!<s: • <br /> Monthly Sewer Constr. <br /> I � £.� �� '� � 5 <br /> � ` <br /> Approved By <br /> �� �.��tl^ y / /� . � City Engineer <br /> ��_e.�. <br /> Issued By <br /> 5�e � OOG,� ,�r�:.., <br /> Connection By <br /> Inspectian By � •�{ '-���--- <br /> Date Inspected.�iZ�� 3 <br /> :� <br /> SE� SKETCH ATTACHED <br /> IIdSPECTION <br /> --- _ — ,.. <br /> i���" .sa�;.�, <br /> �„ih �a i <br /> : V,�a �'n <br /> �f <br /> s k`� <br /> v <br /> ���� <br />. . .. �.i... '.. : . I,..�:. ' � � <br />