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n <br />eVlf 1i � <br />e �— � � —z�—� �% � �//� <br />� <br />City of Everett <br />Engineerin� Department <br />Sewer Application and Perr��'r <br />N0. GO7H�-F DATE ,� l. r, <br />Service Address ' %' '� �� � - <br />Billing Address_ � - <br />City, State, Zip____ � <br />Owner (Mortgagor) � � <br />Billing Name <br />Connection E3y_ _ _ _ . i ; „ <br />Address ' <br />Utility Account No. � � — %-+ % - 1 � J <br />Connection Permit Fee � ' �' (� <br />, <br />Connectioc Fee ' ' • � <br />Total <br />Signed <br />, ': <br />.'J.•�.� /-•✓%!���C� Customer — <br />Phone ' <br />i. , i <br />DESCRIPTION: Sewer District ! % �� , � ,•�, ? /,•� <br />Lot <br />Block_ % / Monthly Sewer Service <br />Division or Addition r� /'/ .''/' ;','�' ' MonthlySewerConstr. <br />T.." n_'—e.. . � <br />SEE SKETCH ATTACHED <br />INSPECTION <br />Trunk �, % � <br />Lateral , . � <br />Abutting Lot Line <br />N, S, E, W <br />Approved By _. '�/;1�/i'i� "� <br />Ci�y Engineer <br />iss�ed ey � �� . � <br />Inspection By /'"�(_ <br />)atelnspected !J <br />N � 20784 <br />