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everetl <br />e <br />City of Everett <br />Engineering Oepartment <br />Sewer Application �r�d �erm�it <br />NO. �). 2_�_ �G DATE ' <br />�z�v <br />Service Address <br />Billing Add <br />�:ity, State, <br />/< � � i .rr'- !,% . <br />�' - -1;3- � _ � �� <br />Utility Account No. <br />Connection Permit <br />_ Connectian Fee - <br />ON-ner (Mortgagor) Total <br />B�Iling Name <br />Connection <br />Signed <br />Customer <br />Phone <br />DESCRIPTION: <br />L_ot <br />Block <br />Division or Add <br />Type Permit: <br />SEE SKETCH ATTACHED <br />INSPECTION <br />Sewer District_ <br />Monthly Sewer Service <br />Monthly Sewer Constr. , . <br />Lateral <br />Abutting Lot Line <br />N, S; E, W ft. <br />Approved By <br />City Engineer <br />Issued <br />inspection By%1/37` <br />Date Inspected /=/.7 �.� <br />No. 2'i ?'i r'. <br />