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edere�i �� / i � <br />� � � � (� , � � <br />; : � �� , <br />, � Y�., <br />, ; � f ;,��,� fJ <br />City af Everett I ' ��! <br />l <br />Engineering Departmeni <br />Sew�r Application ���d �ermif <br />N0. �_;� � C4 :, DATE _ � — <br />5ervice Address <br />Billing Address <br />City, State, Zip <br />Owner (Mortgagor) � ` <br />Billing Name <br />Connection Bv <br />Phone <br />DESCRIPTION: <br />Lot <br />Division or Addition <br />Type Permit <br />Utility Account No. <br />Connection Permit I <br />Connection �ee_ <br />Total Fee <br />SEE SKETCH ATTACHED <br />Sewer District <br />Monthly Sewer Service. <br />Monthly Sewer Constr. <br />Trunk <br />Lateral_ <br />Abutting Lot Line <br />N, S, E, W_ <br />Approved <br />Issued B <br />Engincer <br />� <br />Inspection 8y�--�'� �� <br />/ <br />Date Inspected�.L2i��f <br />NO. <br />