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everett � � � <br /> e . � : , - �� _ _ . <br /> , . <br /> City of Everett <br /> Enyineering Department <br /> Sewer Applicution cnd Permit <br /> N0. � � ;+ '' ' • DATE <br /> Service Address Utility Account No. <br /> Billing Address Connection Permit Fee <br /> City, State, 2ip Connection Fee <br /> Owner (Mortgagor) Total Fee <br /> Billing Name <br /> Connection By <br /> Address Signed <br /> Custortror <br /> Phone <br /> DESCRIPTION: Sewer District _ <br /> Lot <br /> Block Monthly Sewer Service <br /> Division or Addition Monthly Sewer Constr. <br /> Trunk <br /> Type Permit: <br /> Lataral <br /> Remarks: <br /> Abutting Lot Line <br /> N, S, E, W ft. <br /> Approved By <br /> City Enpineer <br /> Issued By <br /> Inspection By <br /> Datelnspected <br /> i <br /> SEE SKETCH ATTACHED N0. ;� �_ �,� O ; <br />