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everett t ^ :� <br />� �. �. <br />City of Everett <br />Engineering & Community Services �'. <br />s, <br />S�vv�r ,�pplication and Perm�t, <br />, <br />CNART NO �L� ��'�`�� <br />�o � %�,�-� '' <br />iZ--l�"' 7 � <br />�,,,,� C` . <br />� / <br />NO. DATE �: �- �� - J G <br />Seruice Address ��' �� � /•:"' -�—Utility Account No. <br />Billing <br />City, State, <br />Owncr (Mortgagor) <br />Billing Name <br />,- < '� <br />Connection By_ - <br />a�d�e55 1 � <br />P'�one <br />DESCRIPTION: <br />Lot _ Block _— <br />Plat - <br />Unplatted Description <br />Permit <br />Connection C <br />Total <br />,>., . , _�_ <br />Signed (`' .t-�y /�:%_._{':�—r-� <br />Customer <br />Sewer District <br />Manthly Sewer Service <br />Manthly Se�ver Constr. <br />Trunk <br />Lateral_ <br />Abutting Lot Line <br />N, S, E, W�_ <br />SEE SKETCH ATTACHED <br />--, _ .,� - . , <br />ItJsPL�':!�P�)��� <br />�1� <br />Approved By ' _. �" ' ' <br />� Ciiy Engincer <br />Issued By '� '` �'—,"'.'- I' <br />Inspection By n���✓r ��`� <br />Date lnspected / � ' � --�` " � � <br />NQ „ <br />N <br />