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,--'. : -- - <br /> everett . <br /> � �_ �1 �� . <br /> City of Everett <br /> Engineering Department <br /> Sewer Application and Perrr,�it <br /> . . ,; ,, � . <br /> � ,: .� ,_ <br /> N0. �0641 DATE � , -- ;,-'. _ - <br /> Service Address �-- _ i' Utility Account No. <br /> Billing Address Connection Permit Fee <br /> City,State, Zip . Connection Fee <br /> Owner (Mortgagor) ' Tot,l Fee <br /> Billing Name <br /> Connection By ' ` <br /> Address Signed <br /> ' Customer � <br /> Phone <br /> DESCRIPTION: Sewer District <br /> Lot <br /> Block Monthly Sewer Service <br /> Division or Addition ! Monthly Sewer Constr. <br /> Type Permit: � <br /> Trunk <br /> Lateral <br /> Remarks: <br /> Abutting Lot Line <br /> N, S, E, W ft. <br /> Approved By <br /> Ciry Enginecr <br /> Issued By <br /> InspectionBy ��/l • <br /> o Date Inspected �J���y <br /> SEE SKETCH ATTACHED No. 2 0 6 41 <br /> ;SPECTIOtJ <br /> _, <br />