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everatt 1 , .,[// V v'-�'� ,. <br />� � �3- 2� � � �-�� �`� <br />� <br />City of Everett <br />Engineering Department <br />Sewer Application and Perr�it <br />N0. �kU 1 � � � DATE � <br />- • ___.. ._ <br />, Z, <br />Service Address ' � - � ` Utility Account No. <br />Billing Address Connection Permit Fee — <br />City, State, Zip � Connection Fee <br />Owner (Mortgagor) Total Fee - <br />Billing Name ` <br />Connection Bv <br />Phone ' <br />DESCRIPTION: <br />Let <br />Block <br />Division or Addit <br />-. . . , <br />, _ Si <br />. ./ ... " _.; /'; <br />nn �� -- - ' • '� � <br />:� <br />SEE SI<ETCH ATTACHED <br />!i!7. .. .i-����,� <br />mer <br />Sewer District <br />Monthly Sewer Service <br />Monthly Sewer Constr <br />Approved By � � <br />Ciry Engineer <br />Issued <br />Connection By — <br />Inspection By � 'i� ��-�✓ <br />Date Inspected �/v/73 <br />�—' <br />