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! <br /> � -_ (�� C�j' _- ,1 <br /> everett - � - � - � � <br /> e - . . � <br /> _ .� �- ,--� , r� <br /> 5 - � —� <br /> City of Everett <br /> Engineering Department � <br /> Sewer Application and Permit 3 4 015 <br /> rvo. 2pg30 <br /> DATE �— / (�' ^ ���� <br /> 1S�� � r, ; ,i ';� Utility Account No. <br /> Service Address -- <br /> Billing Address _ <br /> Connection Permit Fee ' <br /> City, State, Zip <br /> - �-):�%J ,' Connection Fee <br /> Owner �Mortgagor) • Total Fee_ <br /> Billing Name <br /> Connection By ' <br /> Signed " <br /> AC�C�fBSS Customer <br /> Phone <br /> DESCRIPTION: Sewer District <br /> Lot Monthly Sewer Service <br /> Block ,,� <br /> Division or Addition Monthly Sewer Constr. <br /> Trunk <br /> Type Permit: <br /> Lateral <br /> Remarks: Abutting Lot Line <br /> . N, S, E, W ft. <br /> , � <br /> ` , <br /> - qpproved By._ <br /> � - Ciry Engineer <br /> Issued By <br /> — Inspection By <br /> Date Inspected � 'S <br /> 8 SEE SKETCH ATTACHED N�� ? 0 9 3 0 <br /> „!:=PLCIIOiJ <br /> —r_.._. . . ....:__. ._ <br />