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everett � o � `= � <br /> � �y _ �3 .., - � - - ���j <br /> City of Everett <br /> Engineering Depnrtment <br /> Sewer Application and Permit <br /> NO. ��1 � ;� � DATE — <br /> Service Address d��L� �LC/�LdA2Cz�z-- Utility Account No. ' <br /> Billing Address Connection Fe�mit Fee <br /> City,State, Zip Connection Fee__ <br /> Owner (Mortgagor�__ Total Fee — <br /> Billing N�me <br /> Connection By <br /> Acidre;s Signed <br /> Customer <br /> Fhor,e_ <br /> D'�SCRIPTION: Sewer District <br /> ��t T s No��r P �-� 1 <br /> L 2�Z-�3 Monthly Sewer Service <br /> Blc.:k <br /> Division or Addition Manthly 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 /> Ciry Enyineer <br /> Issued By <br /> Inspection By ��'�-�`�u�---� <br /> �------ Date Inspected ��`��� � <br /> o -. <br /> SEE SKETCH ATTACHED Np, £J .1 r ? ? <br /> .f!:�-P`.-�_'.-i i:�I�i . <br /> '�C'i—. L�e' <br />