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� <br />, <br /> i <br />� <br /> ��vtreft l — J � '— 2 �j._ ��–.. <br /> � Lf' — �– �' — 7 5 �-,�, <br /> � <br /> City of Everett <br /> Engineering Oepartment <br /> Sewer Application and Permit <br /> NO. 2�G� � � DATE 3 ���tE) <br /> Service Address Utility Account No._ <br /> Billing Address- , ' ;� Connection Permit Fee -� �'. ; � <br /> City, State, Zip �. �' %� � Connection Fee <br /> Owner (Mortgagor) f�% � r Total Fee <br /> Biliing Name : .'i-'� � <br /> Connection By1� , :;� , ,�„ ',- <br /> ` Address ' Y�.� _ <br /> � Signed_ <br />� � � PhOf1C � Custortrer <br /> ,� DESCRIPTION: <br /> Sewer District <br /> Lot <br /> ' Block Monthly Sewer Service <br /> Division or Addition Monthly Sewer Constr. <br /> i . <br /> . - c � .,.� : <br />� Type Permir. r , } � _,�,� , Trunk <br /> –�— Lateral <br /> Remarks: <br /> �, "�� Abutting I_�t Line <br /> u.K 4 w �P�,„ N, 5, E, W <br /> ,�,W ' ft. <br /> V�C ' c�.a..v. �, � , <br /> .4pproved By_ "' <br /> /5� City Engineer <br /> L/ <br /> Issued By <br /> IInspection By_ ? oo�`a+l2e , <br /> a Date Inspected_ �p� �� 1�17J <br /> SEE SKETCH AT?ACHED N�• G O H H G <br />� � INSpECT10N <br /> E <br /> 1 <br />