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ever�h 1 � <br /> � <br /> � -� � - � ,� � ��rJ <br /> � � � �-� ...�� � �, �/; _ ." /' .%7 � � . <br /> � ' � � � ` � �''� �'l9 <br /> City of Everett � <br /> Engineerinp Department /�J' <br /> Sewer Application and Permit r <br /> 33'739 <br /> rvo. 20759 DATE sy , , �' ! , ' ,' — <br /> Service Address -�' r'"i��i - � :;i - , -,� , --- Utility Account No. <br /> Billing Address �X'�i�-- � •/i T-,u'. ; — Connection Permit Fee <br /> City,Stare, Zip :- �.�. ��;-_;�;� :_���- �� Connection Fee _ <br /> Owner (Mortgagor) � ( F,' r=L,Q, k _-• Total hee _ <br /> Billing Name� ��'_ [='"I �.�f��, <br /> Connection BY-- ,� .�-:. �j. � , �_ <br /> Address. Signed � � i,c ; . < <br /> -�'`_"`—rc�',i.,n,e, <br /> Phone <br /> DESCRIPTION: Sewer District ' <br /> Lot <br /> Block � Monthly Sewer Service __ <br /> Division or Addition �'�'..� - � :i ,, �- i ' �: 1- �. Monthly Sewer Constr. <br /> Type Permit � - — Trunk __� <br /> r ��,. I Y <br /> Lateral <br /> Remarks: <br /> � Abutting Lot Line ' ' <br /> N, S, E, W ft. <br /> _ � <br /> , � � <br /> , Approved 8y i-- <br /> ' -�=.' ` ���r .�., ' Ciry Enpinem <br /> ���,�v � -�� � <br /> Issued By <br /> !nspection By <br /> o Datelnspected `� <br /> SEE SKETCH ATTACHED N�� 2 0 7 5 9 <br /> i � :.n�_CTIO,�: <br /> F <br />� <br />