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i <br /> i <br /> everett �� � �� �� � �� �( � ' - � <br /> e , % .� -,y,� <br /> � � ; <br /> City of Everett <br /> Engineering Department <br /> Sewer �4pp�ication and Permit 1 '� <br /> �) �l . l'f 1 <br /> NO. 2 () �j j 3 DATE <br /> Service Address Utility Account No. — <br /> Billing Address <br /> Connection Permit Fee -' <br /> City, State, Zip Connection Fee <br /> Owner (Mortgagor) Total Fee <br /> Billing Name <br /> Connection By <br /> Signed <br /> /�(�(�fC55 � . — Cusmmer <br /> Phone - <br /> DE:SCRIPTION: Sewer District <br /> Lot_� Monthly Sewer Service _ -- <br /> Block <br /> Division or Addition Monthly Sewer Corstr. <br /> Trunk <br /> Type Permit _ <br /> --- Lateral _ <br /> Remarks: _ Abutting Lo[ Line <br /> — N S E W _it. <br /> :.!_- -- Approved By City Engineer <br /> _ Issued By — <br /> Inspection By�- -- - <br /> Date Inspected� �- � <br /> o----------_ __ ------ � <br /> SEE SKETCH ATTACHED NO. ' <br />