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. ; <br /> �'� I <br /> e��^ret*- <br /> � -_ .B� -,5r. <br /> /'/ — �-o – 7q -S <br /> i.�9. � <br /> i --- j <br /> City of Everett <br /> Engineering Department � <br /> �� <br /> 5ewer Ap�alication and Permit� <br /> , , _ <br /> N0. _. - DATE <br /> Service Address Utility Account No. — <br /> Billing Address � '•��` Connection Permit Fee _ <br /> City, State, Zip _ -'� �. � ! '� Connection Fee ' <br /> qwner (Mortgagor) Total Fee <br /> Billing Name_ <br /> Connection By <br /> Address Signed _ _ <br /> Cusromer <br /> Phone <br /> DESCRIPTION: Sewer District_ <br /> Lot <br /> Block Monthly Sewer Service_ <br /> Division or Addition Monthly Sewer Constr. <br /> Trunk <br /> Type PermiL• <br /> Lateral <br /> Reniarks: � <br /> ': . . .. . : .. .. . .. �-.. .:-. - _. " ,. „_ Abutting Lot Line <br /> � N, S, E, W ft. <br /> ; . . <br /> ;i <br /> -. ., i- -i� . <br /> c_ . <br /> Approved By <br /> Ciry Engineer <br /> Issued By <br /> � Inspection By <br /> Datelnspected <br /> 3 <br /> SEE SKETCH ATTACHED NO. `i' I � r 7 <br />