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7, <br />City of Everett <br />Engineering Department <br />Sewer Application and Permit <br />No. 21238 DATE - --- L <br />Service Addresses O P ul y it Utility Account No. <br />Billing Address <br />City, State, Z <br />Connection Permit <br />Connection <br />Owner (Mortgagor)Sc_— Total Fee <br />Billing Name--- <br />onnection ByyIP�_'C �/ E <br />Address -- -- <br />Phone--I2 5-�-2W-12 <br />DESCRIPTION: <br />Lot -- <br />Block <br />Division or Addition <br />Type Permit: <br />Remarks: <br />T If <br />-16 <br />SEE SKETCH ATTACHED <br />INSPECTION <br />'j <br />� CD <br />���,r <br />Signed _-__—_- -- <br />Customer <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 By <br />City Engineer <br />Issued <br />Inspection By 7�<-/— <br />L� <br />Date Inspected_L _� ---- <br />No. 21.211 <br />