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.CVCfE� ,i.' ��i�j- �~ � <br /> e � �� - .- _, <br /> , � _ . : � ., <br /> City of Everett <br /> Enpineerinp Department <br /> Sewer Applicction flnd Permit <br /> NO. DATE _1%� t / - __�_ _ <br /> Service Address_ Utility Account No.__ <br /> Billing Address Connection Permit Fee — <br /> City, State, Zip __ Connection Fee <br /> Owner (Mortgagor) __ Total Fee <br /> Billing Name <br /> (;onnection By <br /> Address� Signed _____ ___—.. <br /> Cuflamer <br /> Phone <br /> DESCRIPTION: Sewer District____ ___ ___ _ ________— <br /> Lot_ <br /> Block Monthly Sewer Service_______ ___ __ ____. <br /> Uivision or Addition _ Monthly Sewer Constr. <br /> Trunk <br /> Type Permit: -- <br /> �ateral <br /> Remarks <br /> �� ` � --- Abutting Lot Line <br /> _s�wir7�y—L�U�B1'���_/��—. N, S, E, W---- —ft. <br /> _�-&-1�6-- r� <br /> �� " / --- <br /> �T rt'M O�'.N�.v�rG F A: f=f:�' S c-fi APProved BY-- <br /> 3 /e F . Ci1Y Enpineer <br /> —"— — Issued By____._ —_— _ <br /> Inspectian By-1�„ �""� `-� ----- <br /> L ./ <br /> _____________ Date Inspected =3 � L_ <br /> e <br /> S[FSKETCH ATTACNEU N0. <br />