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ererett� _ �_ - <br /> � , .' ��" � <br /> City of Everett _ L� � �� <br /> Engineering Uepartment � <br /> Sew�r �lppiication ar�d Permit i . � - `P ,�� . <br /> N0. QATE _ <br /> Service Address Utility Account Na <br /> Billing Address Connection Permit Fee <br /> City, Sta!e, Lip. __ Connection Fee_ <br /> O�;ner (Mortgagor) Total Fee <br /> Billing Name <br /> Connection By <br /> Address Signed <br /> Customer <br /> Phone. <br /> DESCRIPTION: Sewer District <br /> Lot <br /> 31ock_ Monthly Sewer Service_. <br /> L�ivision or Additian Monthly Sewer Constr. <br /> Type Permit: Trunk_ <br /> Lateral <br /> Remarks;�c ��1. ,S,�e�`-�/ _ <br /> `L Abutting Lot Line <br /> -- N, S, E, W ft. <br />� <br /> Approved By <br /> City Engincer <br /> Issued P� <br /> Inspection By_ <br /> e — <br /> Dat� Inspected �`—�6 ' <br /> SEE SKETCH A7'TACHED Np, `� j ;� `-- ':< <br /> _ ._. ) .. <br />