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,f j ,- <br /> evePctt .—�/% j ;�- rj�`-- <br /> ���� ' � <br /> / � /j:� �� iG •� � 9f� <br /> �� � � � c�g � v� � � - _� ; <br /> City of Everett <br /> Engineering �epartment <br /> Sewer App�acation and Permit <br /> � �, ��, , <br /> � .. � t� <br /> rvo. 2074 �.3b DAT� � i �'� �� � <br /> Service Address_ -�� � � Utility Account No. <br /> Billing Address � ��' � � Connection Permit Fee <br /> City, State, 2ip ' ' ' '- � Connection Fee <br /> � <br /> Owner (Mortgagor) `� Tot:,l Fee _ <br /> Billing Naine ' ' <br /> Connection By " r' " <br /> Address Signed <br /> Cusromer <br /> Phone <br /> DESCRIPTION: Sewer District <br /> Lot i <br /> Monthly Sewer Service <br /> Clock <br /> Division or Addition % � i � � � Monthly Sewer Constr. <br /> , Trunk _ <br /> Type Permit: �� ' <br /> Lateral <br /> Remarks: � Q ,S O –2 – 7 <br /> Abutting Lot Line <br /> � N, S. �, W_ _ ft. <br /> Approved By — <br /> Ciry En6ineer � <br /> Issued By_ <br /> Inspection By <br /> Datelnspected <br /> 0 <br /> SEE SKETCH ATTACHED N�• ',' ! ' `' ` <br /> � <br />