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. <br />� ' <br />, �� , ��- .�:, �i <br /> o - <br /> i everett � I <br /> � _ ., r� _ Z o _. �.9_ -�� '� <br /> — � - � i <br /> � z � , <br /> City of Everett �' Q � <br /> Engineerinp Depertment ��� /�+"l � � <br /> Sewer Application and Permit ' � <br /> N0. � . OATE <br /> ,;,1 , <br /> Service Address _ " ' Utility Account No. <br /> Billing Address " � Connection Permit Fee — <br /> City, State, Zip Connection Fee <br /> Owner (Mortgapor) Total Fee _ — <br /> Billing Name <br /> Connection By — ' <br /> Address Signed �r - <br /> cu+romer <br /> Phone -- <br /> DESCRIPTION: Sewer District <br /> lot_ Monthly Sewer Service _ <br /> Dlock_, — <br /> Division or Addition _--Monthly Sewer Co�str, <br /> Trunk__ _ <br /> Type Permit: ,; <br /> ' Lateral <br /> ; � . <br /> Remarks. ,� ; _ '. ;,:.• - ' Abutting Lot Line <br /> N, S, E, W ft. <br /> — — � <br /> Approved By <br /> Ciry Enpineer � <br /> Issued By _— -- <br /> Inspection 8y <br /> Date Inspected <br /> � SEE SKETCH ATTACHED NO. ? � � R � <br />