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� <br />everett _ , � � � . � � - � <br />�' /, ` .�.. . J i:�/i/% . . <br />v �, � <br />City of Everett <br />Engineering Oepartment <br />Sewer Applicatian and Permit <br />N0. ��N � •; ;- I DATE <br />ServiceAddress 37J���% <br />Billing Addr�-ss <br />City, State, Zip_ <br />Owner (Mortgagor) <br />Billing Name _ <br />Connection By " • —� : <br />Addresc � . . . . .. — ... . <br />Phone <br />DESCRIPTION: <br />Lot <br />Division or Addition <br />�..�.,�n3 <br />Utility Account Nc <br />Connection Permit <br />Connectian Fee_ <br />Total Fee <br />Signed <br />J <br />SEESKETCH ATTACHED <br />Sewer District <br />Monthly Sewer Service <br />Monthly Sewer Constr <br />Approved By <br />Issued <br />Connection By __ <br />Inspection By ___ <br />Date Inspected _ _____ <br />