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:=.� <br /> ��Pn1 J� — /-' - 7 � — �J I - . . _ <br /> i <br /> � / ` � �' J � / . -.�+' I <br /> `. <br /> City of Everett I <br /> Engineering Department <br /> Sewer Application and Permit <br /> 33 � '74 . <br /> No. 20668 DATE _ <br /> Service Address 1 '� � - <br /> Utility Account No. - <br /> Billing Address �- Connection Permit Fee <br /> City, State, Zip ', ` Connection Fee_ <br /> Owner (Mortgagor) i Total Fee <br /> Billing Name <br /> Connection By , '. . <br /> Address � Signed ^ <br /> �:. i <br /> Custumer <br /> Phone ' <br /> DESCRIPTION: Sewer Distr;ct ' <br /> Lot <br /> Block Monthly Sewer Service ` <br /> Division or Addition � • Monthly Sewer Constr. <br /> Tvpe Permii: - Trunk <br /> Lateral <br /> Remarks: <br /> Abutting Lo: Line <br /> N� S� E, W ft. <br /> Approved By ' ��� <br /> City Eneineer <br /> Issued By <br /> Inspection By wr <br /> e Date Inspected_ �O�//�� `� <br /> �� <br /> SEE SKETCH ATTACHED N� � O 6 C� � <br /> �r,iqp�.r-Il�'iJ <br /> —c� <br />