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everett ��" „��"` '�'�� <br /> r,G'�" `> . <br /> e � r�T _:. - ��� <br /> .�a- �_ �, _ ,� � <br /> City of Everett <br /> Engineering Department <br /> Sewer Application and Permit <br /> NO. L � �� �^ � DATE <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 By <br /> Address _ Signed c�siome. <br /> Phone <br /> QESCRIPTION: Sewer District <br /> Lot Monthly Sewer Service <br /> Block <br /> Division or Addition Monthly Sewer Constr. <br /> Trunk <br /> Type Permit: <br /> Lateral <br /> Remarks:RA� ��„�E a �, .c'o �s Abutting Lot Line <br /> _���s �° .c SA`E�c��, N, S, E, W ft. <br /> Z Z �--�c� <br /> � 0 O / i C o.✓.1i <br /> ld .visus� L ia �' ° A roved B <br /> /e s- /t' i .� � 3 , <br /> ' PP Y Ciry EnBineer <br /> Issued By <br /> Inspection By ' <br /> Date I nspected �Q �y <br /> 8 SEE SKETCH ATTACHED NO. `� 1. v � � <br /> I(�ISPEC�i�10'iJ <br /> .--a <br />