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everett <br /> � �� O z� �' � ��� � <br /> City of Everett a ?� <br /> Engineering Department <br /> Sewer Application and Permit <br /> N0. �'. j �- �;� �� DATE <br /> Service Address .p UtiUty Account No. <br /> Billing Address _ Connection Permit Fee <br /> City, State, Zip Connection Fee <br /> Owner (Mortgagor) Total Fee <br /> Billing Name_ <br /> Connection By <br /> Address_ Signed <br /> Customer <br /> Phone <br /> DESCRIPTION: Sewer District <br /> Lot Monthly Sewer Service <br /> Block <br /> Division or Addition Monthly Sewer Constr. <br /> Trunk <br /> ''ype Permit: <br /> Lateral <br /> Remarks: _ Abutting Lot Line <br /> N S E W it. <br /> , <br /> Approved By <br /> Ciry Engineer <br /> Issued By <br /> Inspection By <br /> Date �nspected <br /> a <br /> SEE SKETCH Al'TACHED NO. ;' ]. 5 n �`. <br /> iNSPECTIO�d <br /> .. <br />