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• � - �, -�-8 -5 _ . _ . <br /> '`- ` <br /> ever,:it <br /> _�� ' <br /> � � � -, �� <br /> �� <br /> �-�' � -� <br /> City of Everett C <br /> Engineering Dzpartment � �� 5 U <br /> Sewer Application and Permit <br /> N0. ;�.�OO �� � � DATE I <br /> Service Address ss�� %f�G/�/t�•q y / �-- Utility Account No. <br /> L-illing Atidress <br /> Connection Permit Fee � <br /> City„ State, Zip.�—�� Connection Fee <br /> r����ti p n�c rS <br /> Owi7er (Morigagor} Total Fee <br /> Billing Name - <br /> Connectio� By_ - — ' <br /> i <br /> Address Signed Customer <br /> X phone <br /> DESCRIPTION: <br /> Lot � /- <br /> Bloc::�r <br /> Division or Addition — <br /> ,_ Sewer District <br /> Monthly Sewer Service <br /> Remarks: <br /> � Monthly Sewer Constr. <br /> G � C-'¢�„�-,� 't� -e-�c..-�1` G�' -a-�--�-�`-�`-' <br /> C` �L�., �i`� 1-% � W C,.L�.. � �:-�.,.; APProved By <br /> CitV Enginecr <br /> .P�' � ��— <br /> i' `' ° � ��'� -�,�, -c..�-�- �° Issued BY <br /> � �� GZ� �9 „o�' - <br /> �,.��,�'�, �e.,-� �/`" Ca�J' � Connection By <br /> Q�� � "" � , � � `�- -�- - 7�= <br /> �� � �' ,�!�: /�� "�.�, ___: <br /> Inspection By <br /> � _ �` � C�3 �,.� �-t,,,.�i� .1-u.�. �7 <br /> Date Inspected � �� lv <br /> �1 <br /> SEE SKETCH ATTACHED ��!,,I'�:C�ilGi�l <br />