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,:� <br /> ever,ett � � <br /> U�� � 1 � � ` , � � <br /> , _ , S �� <br /> City of Everett � � <br /> � <br /> Engineering Department <br /> S�wer Application and Permit <br /> � J4�: 6 <br /> No. 20598 DATE _ <br /> Service Address �� !� -� I o; F ��f 1 C������> Util ty Account No. - <br /> Billing :` ddress Cor,nection Permit Fee <br /> City, State, Zip Connection Fee <br /> Owner (�4ortgagor) Total Fee <br /> Billing Name <br /> Connection By _ <br /> Address Signed __h t � I< ( 9-RA T <br /> Cusromc: <br /> Phone <br /> DESCRIPTION: Sewer District <br /> Lot <br /> Block Monthly Sewer Service <br /> Division or Addition Monthly Sewer Constr. <br /> Type Permit: Trunk <br /> Lateral <br /> Remarks: <br /> Abutting Lot Line <br /> N, S, E, W ft. <br /> � � L�,a-,�N s'0 S �� <br /> ,. : (3 C 5 1 ` <br /> Approved By <br /> Ciry Engincer <br /> Issued By <br /> Inspection By��-/���-J <br /> a Date I nspected '`���%�'�`� <br /> SEE SKETCH ATTACHED No, 2 0 � 9 8 <br /> !;�:�I;":!.;-,�i,��i�i <br /> '�__ , <br />