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. :_p <br /> �`eve�ett - � g— . <br /> � - � Z" �- <br /> U � -- ' <br /> , , �. <br /> City of Everett <br /> Engineering Department <br /> Sewer Application and Permit <br /> No. 20602 DATE . ` I J �=�� <br /> Service Address ` � •,= � - Utility Account ��o. - � -, - - <br /> _ T_ <br /> Rilling Address � - _- Connection Permit Fee - �' "' <br /> City, State, Zip Connection Fee '•� <br /> Owner (Mortgagor) Total Fee -- <br /> Billing Name <br /> Connection By � . . - <br /> Address <br /> Signed <br /> Customer <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 /> Remarkr. <br /> Abutting Lot Line <br /> , N, S, E, W ft. <br /> � " � a,�' �° � ' <br /> � ��y � <br /> r+ C50 <br /> Z f <br /> Approved By <br /> Qry Enpineer � <br /> Issued By _ <br /> Inspection By �/T�2c�w <br /> q — Date Inspected �,���7 �{ <br /> SEE SK[TCH ATTACHED N�• � O E� O � <br /> irisr ecr.on� <br /> -.c.__. <br />