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� <br /> i <br />� <br /> I <br /> �,s' s.. r'Y"_c.:� <br /> everett <br /> � r�'-�4 -�4 -5 <br /> �- +� - 7� <br /> City of Everett �� �� <br /> Engineering Oepartment <br /> Sewer �lpplication and Permit <br /> NO. �_ _. .:i ! j DATE <br /> � <br /> Seniice Address Utility Account No. <br /> Billing Address— ' Connection Permit Fee <br /> City, State, Zip Connection Fee <br /> Owcer (Mortgagor) Tutal Fee <br /> Billirg ;Jame_ „ <br /> Conn=ction I3y <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 /> ,. ,,,. <br /> Lateral <br /> Remarks: l�E.✓r ra /y .vFai C`v,✓,v,(-c;.o,�/, <br /> Abutting Lot Line <br /> `� Z 3 .� N, S, E, W ft. <br /> Approved By <br /> City Engineer <br /> , p : a< Issued By <br /> ;�:.':d>;;< . <br /> _ � L i: <br /> . ;F; . <br /> � Ay <br /> '�. �1 �� � <br /> C � <br /> i� ! ;� - Inspection By_L�--Gi`�` � <br />, � :yt� <br />�� t�i� � ``�� ' Date Inspected �� <br /> ..�n'a» , ° <br /> � SEE SKETCH ATTACHED Np• 2�L 31 J <br /> � ;. <br /> ' I!1SPECT ION <br /> � .'-, <br />