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everory /�G S � G= � , ., . r �•-i - - <br /> '/�` ) ., . , . _ , : <br /> e � , � �-_ r�- z q_ s-- _, ._-��,�-.,�- �, ,��p '�-'� <br /> � - �. � - � � r,.. .�/. -�.- i� r- <br /> _ , � <br /> City of Everett � ;,-.(�� � . ; , � `� � � �,��'N <br /> Enpineering Department • <br /> Sewer Application and Permit <br /> NO. l ��. r' i 1 DATE <br /> Service Address Utility Account No. <br /> Billing Address Connection Permit Fee <br /> City,State, Zip .' r ' Connection Fee <br /> Owner (Mortgagor) Total Fee <br /> Billing Name <br /> Connection By . <br /> Address Signed <br /> cu:tomer <br /> Phone <br /> DESCRIPTION: Sewer District <br /> Lot <br /> Block Monthly Sewer Service <br /> Division or Addition Monthly Sewer Constr. <br /> Type Permit: Trunk <br /> Lateral <br /> Rernarks: <br /> Abutting Lot Line <br /> N, S, E, W ft. <br /> Approved By <br /> City Enpineer <br /> Issued By <br /> Inspection By <br /> a Datelnspected <br /> SCE SKETCH ATTACHED � �, 7 <br /> NO. i_ .� �_ �� � <br /> .��'.I:�r il C f�,l <br />