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/: <br /> . / <br /> evergtt <br /> r; � <br /> � �- I �,, ' �,�� <br /> �� <br /> City of Everett � ✓ ~ <br /> Engineering �epartment <br /> r <br /> Sewer Qpplication and Perre�it ) � <br /> � �+b2i, <br /> i <br /> rvo. 3�0 2 7 9 DATE �� -��" ! �-- <br /> Service Address � �-� � '� ' � • '"t Utility Accaunt No. �'-� ' `1 / ''� "� �"� <br /> Billing Address •�' � - '- � > � � �A `� Connection Permit Fee l ^�� / <br /> City, State, Zip " '-` �- -+'� - T ' ��% i�r �-' '•' Connection Fee ' ? � <br /> Owner (Mortgagor) - : � ' - - J : �= Total Fee �� "'• � `' - <br /> i <br /> Billing Name -- ^� ,' � �_ �, <br /> Connection By_ - ' � � - ' <br /> Address i �. ,.v /� S�� , i� •, - r c,✓: Sfg�.ed_ ' ; - . ---� <br /> Cusmmcr <br /> Phone �; , r" - i ., �, <br /> OFSCRIPTION: <br /> Lot --=? <br /> Block - <br /> Division or Addition = `-� • �� <br /> __-- <br /> — Sewer District ' <br /> �:: s <br /> Remarks: _ Monthly Sewer Service " _ <br /> � h • ' , % :: . -,- � . __ • , <br /> Monthly Sewer Constr. ` <br /> y'����-'� '� '6 '��r";� SP,Z`' �: '� <br /> �• �n C' lG, � r Approved By '�' :-!. c1 • � <br /> � Ciry Engineer <br /> Issued By � � � <br /> Connection By <br /> �, ' <br /> � ,.. - �.��.-,-� <br /> Inspection By <br /> Date Inspected 7���/ �3 <br /> �' <br /> � <br /> SEESKETCH ATTACHED <br /> �:�S��i- , I�`r <br />