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� <br /> everett � <br /> ,�,",�E • ��� r7'-�-�- �_� <br /> City of Everett . /�— �YrZ�— �^_ <br /> Enpineering Oepartment <br /> S��wer ��p�c��ati�n �s�d P�e�r�et . <br /> rvo. 21G�4 DATE - - i �-, I <br /> . S^rvice Address_,2 �/Lj (2 S/I )�� <br /> �-�,� Utility Account No. <br /> Billing Address � Connection Permit Fee s~- <br /> City,State, �ip % _ , � I <br /> � �, ` � Connection Fee <br /> Owncr (Mortgagor) - - _ � • �f <br /> Total Fee .� � <br /> Billing Name <br /> Connection By - <br /> . , , — _ _ ;'L, <br /> Address �� - <br /> ' Signed ��,i �'�.��.l� ( <br /> . <br /> Phone - � c��om�, � / <br /> ., <br /> _ �, <br /> DESCRIPTION: <br /> Lot '�4- -�_ Sewer District <br /> Block_ c"/ / , � Monihly Sewer Service � <br /> Division or Addition -'- ;'% �' ' ' � <br /> . . Monthly Sewer Constr. <br /> Type Permit: Trunk <br /> Remarks: <br /> ^ " Lateral <br /> Abutting Lot Line <br /> � �� N, S, E, W <br /> n e.,., . �szas� -�-�—s_,J ,.�,T-- ft. <br /> 1�G i 5 ' . <br /> � Approved By � • / <br /> City Enpineer � <br /> . . � �.,/ ' � � ' <br /> Issued By ;; , �', <br /> -�_ <br /> , • . C . <br /> Inspection By_.,� � �,� <br /> � . Uate Inspected_�� <br /> SEE SIC[TCH ATTACHED NO. �21684 <br /> INSPECTION <br />� <br /> 1 <br />