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everett <br /> e � � , � <br /> , ., � � <br /> City of Everett <br /> Engineerinp Depertmant � i <br /> Sewer Application and Perrr�it <br /> NC. �'� I �� I. �! DATE <br /> Service Address�(L� ��/7�?,� Utility Account No, <br /> Billing Address__ _ Connection Permit Fee ,1 <br /> City,State, Zip � � ,�_ Connection Fee _ <br /> Owner (Mortgagor�_;_:_. . Total Fee <br /> Billing Name • r <br /> Connection By <br /> Pddress _ Signed . ,' , i , <br /> Custamar <br /> Phone <br /> DESCRIPTION: Sewer District <br /> Lot_���.� <br /> Block / Monthly Sewer Service <br /> Division or Addition Monthly Sewer Constr. <br /> Type Permit: Trunk <br /> Lateral <br /> Remarks: <br /> , Abutting Lot Line <br /> ` N, S, E, W ft. <br /> Approved By <br /> � City EnpineM <br /> Issued By <br /> Ilnspection By <br /> __ . - _ I Date I nspected_� <br /> o —— <br /> SEE SKETCH ATTACHED NO. " � �� �( ��. <br />