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evergtl , <br /> � r' I -- i.� �_ � � ; /! <br /> —' ; <br /> �� �I i' Q ' 7 <br /> � 2 <br /> Ciry of Everett � �� � �����`� <br /> Engineerinp Depariment <br /> Sewer Application and Permit <br /> J „ `� 1 <br /> No. 2 0 G 2 3 DATE <br /> , <br /> , <br /> _ <br /> Service Address Utility Account No. <br /> Billing Address Connection Permit Fee <br /> City, State, Zip Connection Fee J� <br /> Owner (Mortgagor�� ' Total Fee <br /> Billing Name I <br /> Connection By S <br /> .' '. �' '��;,., ��.r:,; �, �t.': . ... • <br /> - � <br /> Address Signed I1 ' ..f„f ,µ_. .�_ <br /> cu:mme. <br /> Phone � <br /> DESCRIPTION: Sewer District _ <br /> Lot <br /> Block_ _ Monthly Sewer Service <br /> Divisian or Addition � Monthly Sewer Constr. <br /> Trunk <br /> Type Permit: <br /> ' Lateral <br /> Remarks: <br /> Abutting Lot Line <br /> N, S, E, W_ ft. <br /> — Approved By <br /> Gty Engine0f <br /> �SSU@(� BY_a— <br /> InspectionBy K� CQ//�/o� <br /> Datelnspected S/���7�/ <br /> a <br /> _� SEE SKETCH ATTACHED N0. " ; , <br /> . _ , <br /> ��__,_ � <br />