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everen . <br /> e . _ -. :.. :._. <br /> � f , ,. ; � <br /> r <br /> 7 : �,, ,, !.j _ z,q _ e�' <br /> � . <br /> city ot Ever�n l r �• � '• - �'� <br /> Enpineerinp Depe�tment <br /> Sewer �►pplication and Permit <br /> NO. .� �� '� '�� - DATE <br /> Service Address Utility Account No. — <br /> Billing Address Connectian Permit Fee <br /> City, State, Zip Connection Fee _ <br /> Owner (Mortgagor) _ Total Fee_ ___— <br /> 8illing Name <br /> Connection By — <br /> Address Signed __ <br /> customer <br /> Phone_ <br /> LESCRIPTION: Sewer District <br /> Lot <br /> Block Monthty Sewer Service <br /> Division or Addition Monthly Sewer Constr. , <br /> Trunk <br /> Type °ermit: <br /> �ateral <br /> Remarks: <br /> — Abutting Lot Line <br /> N, S, E, W ft. <br /> � �,i ���/ <br /> Approved By <br /> Ciry En9ineer <br /> Issued By <br /> , , , <br /> Inspection By ��r'� ''�'rt, —= <br /> _ _ Date Inspected '�-� y 74• __ <br /> Y <br /> SEE SKETCH ATTACHED �!0. <br />