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. i <br /> everett <br /> � . <br /> . - � ' � � ' ._ � � _�-- - . <br /> � <br /> City of Everett . <br /> Engineering Department <br /> Sewer Application and Per�it <br /> 33667 <br /> ,- - , � <br /> N0. f i� ( �_ �J DATE <br /> Servir.a Address - Utility Account N <br /> Billing Address___ _ Connection Permit Fee <br /> City, Stat�, Zip _ Connection Fee <br /> Ownc� fP4crtaagor) � ! _ Total Fee <br /> �..il"..,.. .�.me <br /> Connectian By � _ <br /> Address _ _ Sigred <br /> Cusromer <br /> Phone <br /> DESCRIPTION: Sewer District <br /> Lot <br /> Block Monthly Sewer Service <br /> Division or Acldition Monthly Sewer Constr. <br /> Trunk <br /> Type Permit: <br /> Laterel <br /> Remarks: <br /> Abutting Lot l.ine <br /> _ � "�, S, F, W f[. <br /> Approved By <br /> Gq Engineer <br /> Issued By <br /> Inspection By �--f=`- �`— �--� <br /> � —_ Date I nspected 7— �� '7��-- _ <br /> SEE SKETCH ATTACHED N0. � '1 <br />