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everett �- 0 "� Z �- �� <br /> � ��5 t�b--'— c� C/2�/7 �. <br /> � , <br /> � �/.�/, <br /> � , .-, . <br /> City of Everett <br /> Engineering Oepartment <br /> � <br /> Sewer Application and Permit <br /> NO. 2 i C Q � DATE <br /> Service Add�ess Utility Account No. <br /> Billing Address. Connection Permit Fee_ <br /> City, State, Zip Connection Fe=__.._____ <br /> Owner (Mortgagor) Total 1=ee___ <br /> Billing Name <br /> Connection By <br /> Address Signed <br /> Customcr <br /> Phone — <br /> DESCRIPTION: Sewer District <br /> Lot �4onthly Sewer Service <br /> Block <br /> Division or Addition ivlonthly Sewer Constr. <br /> Trunk <br /> Type Permit: <br /> Lateral <br /> Remarks: <br /> Abutting Lot Line <br /> N, S, E, W ft. <br /> Approved By_. <br /> City Enginecr <br /> Issued By <br /> ------- - — -- C � � S� , . <br /> Inspection By ���-- <br /> Date l nspected � ' ' 3�—� c <br /> e <br /> SEE SKETCH AiTACHED NO. ? 1 O O 3 <br /> Ii;''�PECTION <br /> -, <br />