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@ <br />everett ^ <br />� <br />City of Everett <br />Engineering Department <br />Sewer Application and Permit <br />N0. L_� C 8� DATE ' �-; ; <br />� r ' <br />Service Address �'L-FM/�./G Utility Account <br />Connection Permit Fee ' � <br />i , �.� � -� ., , r <br />Biiling AddrPss <br />City; State, Zip � - ' � � Connection <br />Owner (Mortgagor) - � � � ��` � i � r �- � - Total Fee "-! �` <br />Billing Name <br />Connection E <br />Adcress_ <br />Phone_ <br />Signed • ;' �;;'' <br />� - -- � cu:toreer' � <br />DESCRIPTION: Sewer District <br />Lot� Monthly Sewer Service. <br />Block <br />Division or Addition�lt ��� Monthly Sewer Constr. <br />SEE SKETCfi ATTACHED <br />'r, <br />Lot Line <br />,S,E,W. <br />i BY City Enpineer � � <br />n Bv <br />Na 21 G8� <br />