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evcrc� <br />e �_ _ <br />City of Everett <br />Engineering Department <br />y <br />� � . � � _.- <br />Sewer Application and P�rmit <br />N0. 2 [) �j (� �j DATE <br />Service Address� % _ ' f' '' � Utility Accuunt No. <br />� <br />9illing Address_ � Connection Permit f <br />City, State, Zip_ ,i f�- � Connection Fee_ <br />Owner (Mortgagor) ' � ,� y,Total Fee <br />Billing Name <br />Connection Bv , . . <br />Address . � > <br />, . --r=, '� � �.-- <br />Phnna � �' . .- . -.- � � <br />DESCRIPTION: <br />Lot ' <br />Biock <br />Division or Addition <br />Type Permit: , <br />Signed <br />Customer <br />SEE SKETCH ATTACHED <br />INSPECTION <br />Sewer District <br />Monthly Sewer Service <br />Monthly Sewzr uonstr. <br />Abutting Lot Line <br />N, S, E, W — <br />Approved By ` " _ <br />� Qty Enpidem <br />ISSUC(j <br />Inspection By ,,�� _ <br />�atelnspected ��Z`��7y� _ <br />No. 206Q6 <br />