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everett , ��� <br /> y, - ' � z -� �, - ; <br /> e . � � <br /> ' '�'�' ` �� �'�����' <br /> City of Everett <br /> Engineering Department <br /> Sewer Application �nd Permit 33662 . <br /> rvo. 2 0 716 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 <br /> Customer <br /> Phone <br /> DESCRIPTION: Sewer District _, <br /> Lot <br /> Monthly Sewer Service '• ' <br /> Block <br /> Division or Addition Monthly Sewer Constr. <br /> Trunk ' <br /> Type Permit' _ , <br /> Lateral <br /> Remarks: <br /> Abutting Lot Line <br /> N, 5, E, W ft. <br /> � . . <br /> Approved By ' ' <br /> City Engineer <br /> Issued By <br /> Inspection By �OO <br /> Date 1 nspected� 'Z S,� 7 � <br /> 0 <br /> SEE SKETCH ATTACHED N�� 20716 <br /> If:�.,-,- � ��: i;! <br /> y_�_i <br />