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evere� ^ �, <br /> � �- � �'�� , ,� .� <br /> ` `�,_J,_T �. <br /> � t:, � . <br /> i / �k.�jj <br /> /-�'Z 9� l `1 �, <br /> City of Everett <br /> Engineerinp Oepartment , <br /> Se�tier Application and Permit <br /> "o. 21013 DATE <br /> Service Address ' � ; � Utility Account No. <br /> Billinp Address ' Connection Permit Fee <br /> City,State, Zip Connection Fee <br /> Owner (Mortgagor) � i Total Fee <br /> Billing Name <br /> Connection By <br /> Address ' ' Signed <br /> Customer <br /> Phone _. " <br /> DESCfiIPTION: Sewer District_ _ <br /> Lot <br /> Block -� =7 _ , Monthly Sewer Service <br /> Division or Addition - � . ' Monthly Sewer Constr. <br /> Type Permit: Trunk <br /> Lateral <br /> Remarks: �'aM�'l,E7,Gp — y� .., :�,�,.. ur <br /> /k�buttiny Lot Line <br /> n�,..s�rt„�nsa. , N, S, E, W ft. <br /> , , . . <br /> __� c` . s 't.r <br /> ��RJ.ZT Y G�w�.]] l/G�S��y�E e, <br /> -_i <br /> /� �p Approved By_. <br /> __�CYYIAI �' G�AUt1�$ �r L1 S CnyEnpmeer <br /> _ ["b�y p.�G v m i' �. Y�! V�tI • <br /> �� Issued By <br /> — /" <br /> � Inspection By�'('�- � � �� <br /> Date Inspected_�,"��� <br /> o . — <br /> SEE SKETCH ATTACHED Np• I i n � � <br />