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everett � � <br /> � '� _ �(� '�'��`�.�" _ <br /> ; , . �_ <br /> City of Everett <br /> Engineering Oepartment a��� p G <br /> Se^,�ver Rppli�ation and Perm�t <br /> NO. �_.iI 'JI _I. ✓ DATE <br /> Service Address � ��q � �M.�iA.E'.O Utility Account No. _ <br /> Billir.g Address Connection Permit Fee <br /> City, State, Zip Connection Fee <br /> Owner (Mortgagor) To� +t f-ee__ <br /> Billing Name _. <br /> Connection By _ <br /> Address_ Signed_ <br /> Customer <br /> Phone � –' <br /> DESCRIPT.ION: � <br /> Lot <br /> Block '�� <br /> Division or Addition_ • <br /> Sewer District <br /> Monthly Sewer Service <br /> Remarks: ,�j����' — <br /> ��`�� �� ���� ���.� ^ Monthly Se•.ver Cons[r. <br /> �.v,U, — <br /> � "� a v D �o a�i.l ' <br /> �Oo. Approved By_ _ <br /> City En�ineer <br /> Issued By _ <br /> -- Connection By _ . <br /> Inspection By_L- Cul�/.✓ _ <br /> Date I nspected ��/���� <br /> � <br /> �.7 <br /> SEFSK[TCH ATTACHED <br /> - � <br />