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i.� 'v. � � .� .~��/ <br /> evereri � ` <br /> � �� ��n � � Q � S� <br /> City of Everett <br /> Engineerinp Department <br /> Sewer Application and Permit <br /> , . , DATE <br /> N O. �- . <br /> Ser�ice Address Utility Account No. <br /> Billing Address Connection Permit Fee <br /> City, State, Zip Connection Fee <br /> Owner (Mortgagor) Total Fee — <br /> Billing Name <br /> Connection By , <br /> Address Signed_ <br /> cwromer <br /> Phone <br /> DESCRIPTION: Sewer District <br /> Lot Monthly Sewer Service � <br /> Block I <br /> Division or Addition Monthly Sewer Constr. <br /> Trunk _ <br /> Type Permit: <br /> Lateral <br /> Remarks: — Abutting Lot Line <br /> s'_ i�. <br /> . N g E, W ft. <br /> f . ;� .� <br /> Approved By_ <br /> c��v e�o��em <br /> Issued By <br /> _— __— �1�K1Aw-�� <br /> Inspection By , <br /> __ Date Inspected 7_S � ._yz�� — <br /> 0 <br /> SEE SKETCH ATTACHED NO. � �•�� ii il <br /> � <br />