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1 <br /> ,; <br /> everefl .,�D ' . ` �_ � 1 <br /> e � - � �� <br /> �. , - .�,,.� <br /> �, . <br /> City of Everett � <br /> Engineering Department <br /> Sewer Application and Permit <br /> :i �'.81:7 <br /> NO. �� 2 � � DATE <br /> Service Address -��� � Utility Account No. <br /> , <br /> Connection Permit Fee <br /> Billing Address ' <br /> City, State, Zip <br /> Connection Fee <br /> pwner (Mortgagor) Total Fee <br /> Billing Name <br /> Connection By — <br /> Address ' Signed c�s�onx� <br /> Phone , <br /> DESCRIPTION: <br /> Lot - � <br /> Block — <br /> Division or Addi[ion <br /> Sewer District - <br /> Monthly Sewer Service <br /> Remarks: � <br /> Monthly Sewer Constr. , <br /> � , <br /> .a�,.���-`. <br /> . � <br /> ' � i ^ 4 Appraved By �I <br /> C��V Engineer <br /> Issued 8y . j <br /> Connection By <br /> Inspection By � Q�"'"'"'� I� <br /> Date Inspected �����7 7 <br /> � <br /> il.� � <br /> SEE SKETCH ATTACHED �, i, I <br /> I <br />