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. Z / �7 Q,-, <br /> / , , <br /> evercit T — � /� ' �_ � — `�- , "�'� U l /5���1` <br /> � �� . . � �f . <br /> City of Everett <br /> Engineering Uepartment <br /> Sewer Application and Permit <br /> , , :: ,,_� <br /> 33 �:;'' � <br /> No. 2 0 � 31 DATE <br /> ServiceAddress - -- �- f = '� -�+✓f= UtilityAccountNo. <br /> Billing Address � ' ' !� Connection Permit Fee ---- — � <br /> City, State, Zip _ ' `_ �' ':I'� Connection Fee <br /> Owner (Mortgagor�" . t Total Fee <br /> Billing Name <br /> ;.. _ <br /> Connection By -�� F r <br /> � �, � � <br /> � r <br /> Address : '���.:�: Signed i- <br /> . � 1 � ' Customer <br /> Phone f - ,`+ �' <br /> DESCRIPTION: Sewer District ' � <br /> Lot - <br /> Biock Monthly Sewer Service <br /> Division or Addition Monthly Sewer Constr. <br /> ii <br /> Trunk <br /> Type PermiL - <br /> � - i Lateral <br /> Remarks: <br /> Abutting Lot Line <br /> �--L , - � , N, S, E, W it. <br /> i, �� , <br /> D....L+.c.�ClX ��n p1 '? � P. . � <br /> Approved By <br /> City Engineer ' <br /> Issued By � <br /> Insper,tion By <br /> Datelnspected <br /> 0 <br /> SEE SKETCH ATTACHED N0. 2�g�� <br />