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. . . �; <br /> � <br /> everett ' <br /> � � � 'f I <br /> � � <br /> City of Everett <br /> Engineering Department <br /> Sewer A,pplication and Permit 3zsls <br /> N0. ��� 1 L� �. DATE -- _ I' <br /> _ I <br /> Service Address ' ' Utility Account No. <br /> Billing Address Connection Permit Fee I <br /> City, State, Zip Connection Fee ' <br /> Owner �Mortgagor) '"" � ` Total Fee - <br /> Billing Name <br /> � . .. ,. - -r. , r.- -7: 1 �.�� , . ' <br /> Connection By / _ .1 <br /> ♦J � S ' ' „ � <br /> Address - - ��-� `' '� �' ����e�-- � Customer� <br /> Phone <br /> i .; i :; <br /> DESCRIPTION: <br /> Lot - <br /> Block_ <br /> Division or Addition__��"�f � 7� i'1 V ' <br /> Sewer District <br /> Monthly Sewer Service <br /> Remarks: - .; ., �,.: ,_ ,� ., ; ; ':� <br /> Monthly Sewer Constr. <br /> la.�.�,cu.�-�. c�c��C N �5 � G /i 'w <br /> ^�� s �a.,,,,� �°''""'� � o APPraved By �.; ' ' - wi a� <br /> ��—� p City EnBineet <br /> ,'�� <br /> �p� /� Issued By <br /> N� 5 67q (�/ i1�t /JC \ � <br /> Connection By <br /> Inspection By <br /> ,0,o-�...,_.,_- <br /> Date Inspected �/vG�73 <br /> ,�—. <br /> :� <br /> SEE SKETCH ATTACHED �� <br /> INSPECTION � ��, <br /> � � � <br /> :A^,_. <br /> �;v <br />