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\ - , <br /> everett <br /> � � <br /> City of Everett <br /> Engineering Oepartmer.t <br /> �ewer ApRlication and Permit I <br /> �O. DATE � <br /> Service Address_�l.Q��� Utility Account No. <br /> Billing Address Connection Permit Fee <br /> City, State, Zip Connection Fee <br /> Owner {Mortgagor) Total Fee � <br /> i � <br /> Billing Name <br /> Connection By ' <br /> 1 <br /> Address Signed <br /> c�,s����„E, �i <br /> Phone <br /> G'ESCRIPTION: Sewer District <br /> Lot�Z—�_ <br /> Monthly Sewer Service <br /> Block�L�_�_ �� <br /> pivision or Adriitinn�/I�f[�-�� Monthly Sewer Constr. <br /> Type Permit: � Trunk_ <br /> --������ <br /> Lateral <br /> Remarks: <br /> Abutting Lot Line <br /> � N, S, E, W ft. <br /> 4,% . <br /> r � . <br /> — Approved By <br /> City Engineer <br /> Issued By _ <br /> inspection By --- <br /> Dab: lnspected _ <br /> a <br /> SEE SKETCH ATTACHED �!0. <br /> . � <br />