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.-.. . � � <br />everett <br />� <br />City of Everett <br />Engineering Department _ <br />Sewer Applicction and Permit <br />NO.������ � DATE <br />Service Address 3 �Z � - <br />Billing Address <br />�City, State, 2ip <br />Owner (Mor[gagor) < <br />Billing Name <br />Connection By /�• L�/1' ' E E,Li <br />Address <br />f'hone ' <br />DESCRIPTION: <br />Lot <br />Block _ <br />Division or Addition <br />Utility Account No. <br />O a <br />Connection Permit Fee .3 � - <br />Connection Fee il/o,t/E <br />Total Fee - � <br />Signed <br />� <br />Sewer District _ <br />Monthly Sewer Service _ <br />Monthly Sewer Constr. <br />� <br />SEE SKETCH ATTACHED <br />Approved By `' <br />Cny Engmeer <br />Issued <br />�onnection By <br />Inspection8y—/� C_a(�G(�,�,J <br />)ate I nsoected �-2 - I- 7 t <br />