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� <br />�e�R <br />e <br />City of Everett <br />Engineering Department <br />�� r� C� ��_ <br />� <br />/ � ( J <br />;� <br />�^ <br />Sewer Application and Permit <br />NO.���47rJ j DATE _ �, ''`�� <br />Service Address � �� � =� '`� r- 1_�'"� � / � �- Utility Account No. <br />Billing Address f Connection Permit I <br />City, State, Zip -- �� `' 'T� <br />Owner (Mortgagor) - ! �-� <br />Billing N <br />Connection F <br />Total F <br />e _�.�. <br />� -� i <br />Connection BY,. '7 i= �/= h f' �? ✓ �= <br />l 1. f <br />( <br />� 7 � i.- cJ J=. i<� ~''T �`i���• Signed 'f 's..�:-ti� ��'} '� ..._,: j�� <br />Address c�:�om�� <br />,-__,-/-,� ! --' 2 <br />Phone > .� <br />DESCRIPTION: <br />Lot � <br />Block � �'' _� , � <br />Division or Addition_ � '=' �' '-- �! ' `� � �� �� , <br />Sewer District " <br />� <br />SEE SKETCH ATTACHED INSPECTIO(` <br />Monthly Sewer <br />Monthiy Sewer Constr <br />Approved By �`�, r�;�f�/�l (/ij%:� <br />Ciry Engineer <br />�" / ,:1: <br />Issued Bv <br />Connection B <br />I nspection By—� � u l�G � a'� <br />Date I nspected ` y� 7`� <br />