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� � <br /> everet� i��S 7`E�( <br /> � �� ? C - . . r ;i 'r : <br /> City of Everett <br /> Engineering Department <br /> 5ewer Appliecation and Permit <br /> N0. : _ - DATE <br /> Service Address Utility Account No.. <br /> Billing Address Connection Permit Fee <br /> City, State, Zip ____ __ Connection Fee <br /> Owner iMortgagor) Tctal Fee —___ — <br /> Bif�ing Name <br /> Connection By <br /> Address Signed — <br /> Custamer <br /> Phone <br /> DESCRIPTION: Sewer District <br /> Lot <br /> Block Monthly Sewer Service__ <br /> Division or Addition Monthiy Sewer Constr. <br /> Trunk <br /> Type Permit: <br /> Latere{ <br /> Remarks: I <br /> Abutting Lot Line <br /> _,�o � �.C� � 2e .�.--e� N, S, E, W ft. II <br /> �L����. � <br /> Approved By <br /> City Engineer <br /> Issued By <br /> y�/���- — <br /> Inspection By ��T�-l�%'�=�'�--� <br /> Date Inspected�L`���G <br /> e <br /> SEE SKETCH ATTACHED N�• , ' �' i <br /> ':.�f'GCTION <br />