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� <br />� <br /> � ) � _� ,I�l ��7_.>_ � <br /> �` ,-� ���_� �' <br />� everett '�'�� , '� � � <br /> , �, <br /> e � _ � , - � �� _ � <br /> �, _ � <br /> City of Everett <br /> Engineering Department <br /> Sewer Applicatiori and Permit <br /> NO. i _�_ E� i `� DATE � � � <br /> �ervice Address�����/�G�r.E�L'� ` Utility Account No. <br /> / <br /> Billing Address ' �' Connection Permit Fee <br /> City, State, Zip- . Connection Fee <br /> Owner (Mortgagor) Total Fee <br /> Eilling Name <br /> Connection By <br /> Address Signed — <br /> Customer <br /> Phone <br /> DESCRIP710N: Sewer District <br /> Lot ;1�— Monthly Sewer Service <br /> Block <br /> Division or Addition���.��%/��1� Monthly Sewer Constr. <br /> Trunk <br /> Type Permit: A��r(�� <br /> H Lateral <br /> Remarks: Abutting Lot Line <br /> N S E W ft. <br /> Approved By ' <br /> Ciry Engineer <br /> Issued By <br /> T � <br /> / �Inspection By_,/��� � Zu""'' <br /> Date I nspected ��3�J� <br /> e SEE SK TChI ATTACHED No. 21618 <br /> :;P�CTION <br />