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eU <br />City of Everett <br />Engineering Department <br />Sewer Application and Permit <br />NO. 2_ <br />Service Address <br />Billing Address <br />City, State, Zips <br />Owner (Mortgagor) <br />Billing Name_ <br />Connection <br />DESCRIPTION: <br />Lot <br />Block /yi_ 2q-Lq -�- <br />Division or Additinn <br />Type Permit: <br />DATE f I <br />SEE SKETCH ATTACHED <br />INSPECTION <br />Utility Account No. <br />Connection Permit f <br />Connection Fee <br />Total Fee <br />2�q_s <br />RECEIVED <br />6EP zo 1976 <br />.UTILITY DEPARTMENT <br />Signed <br />Customer <br />Sewer District <br />Monthly Sewer Service <br />Monthly Sewer Constr. <br />Abutting Lot Line <br />N, S, E, W <br />approved By <br />City Engineer <br />ssued By. <br />ispection By /V 7 <br />ite 1 nspected <br />No. 21478 <br />