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everett <br /> � ,-_ g _z�'_s �,��� �/���` <br /> e : � <br /> City of Everett <br /> Enginesring Department <br /> Sewer Application and Permit <br /> _ . , 3368� � <br /> N��. 20729 - , _ , ,, <br /> DATE <br /> Service Address --'- _% '. � '%'�,- '-�� % '�,'=� Utility Account No. _. -- =- i � `� , ' �%� <br /> BillingAddress �� '� �-���- � , � _� � �%--'� Connection Permit Fee � ' "- <br /> City, State, Zip ` +?-- ' + �'< Connection Fee � " <br /> Owner (Mortgagor) ` 1 � �':.i ; ,t,;. � -..' Total Fee <br /> , � - <br /> Billing Name �' ��-/� <br /> Connection By �Y ;7'-�:* ' i�'i l I <br /> I <br /> Address "��%-`^ - ! ? J;� }i.-i � Signed ' j <br /> ' �� Cusromer � <br /> Phone i_ ;� .. ^� �- <br /> DESCRIPTION: Sewer District - �' %-�, <br /> , ._. <br /> BI ck Monthly Sewer Service �� —� <br /> Division or Addition ' ' � "� �� Monthly Sewer Constr. <br /> , �' � <br /> Trunk � <br /> i : <br /> Type Permit ,. � , �._-�. ;, <br /> � I_ateral <br /> Remarks: <br /> Abutting Lot Line <br /> N, S, E, W -' ft. <br /> Approved By <br /> `Clty EnOineer � <br /> l;sued By -- <br /> Inspection By <br /> Date Inspected � � / <br /> 0 <br /> SEE SKETCH ATTACHED NO. ',' �l ? '� n <br /> -�7 <br />