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ev�ren � • � - <br />S� <br />U � � . <br />� <br />� -�c� -�;'�1 -5 ! � �/3/7s .—f�.� <br />City of Everett ;���� <br />Engineering Department <br />Sewer �►,ppiication ant� Perenit <br />N0. �' U 7 �p' { DATE <br />� <br />Service Address �`?� �- Utility Account No. <br />Billing Addre , Connection Permit Fee_ i - <br />City, State, Zip i � ,�y <br />, Connection Fee <br />Owner !Mortgagor�_ - �, - Total Fee <br />Billir,g Name '� �" - <br />Connection By <br />Address �l � ��?!.�/l�-� T �: _.__ <br />, Signed <br />PhOnC._, � � ' � Cusror�er <br />DESCRIPTION: <br />Sewer District - <br />Lot _ — <br />Division or Addit <br />Type Permit: <br />Remark<: <br />—� <br />SEESKETCH ATTACHED <br />Monthly Sewer Service <br />Monthly Sewer Constr. <br />Lateral _ <br />Abutting Lot Line <br />N, E, W <br />Approved By <br />City Engmcer � <br />ISSUCd <br />Inspection By_�, _ _ <br />�ate Inspected /� !` <br />NQ „-- <br />_it. <br />