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everett �' -i _ 1 °1 -2`� - `�� . 1 <br /> � ,t:� .�� ,-�� <br /> jl` ' <br /> City of Everett <br /> Enqneering Oepartment 3 2 3 6 8 <br /> Sewer Application and Permit <br /> NO. �.O O 4 7 DATE � � � <br /> , . _ <br /> Service Address ' ' ` ' ' ' � � ' - • Utility Account No. `� l <br /> Billing Address Connection Permit Fee ' <br /> City, State, �ip_ Connection Fee <br /> Owner (Mortgagor) ` = Total Fee ' <br /> Billing Name <br /> Connection By - _ �: t- + - i�-- ;. ; - ,�- _ <br /> Address - ' ` - - , ' - Signed � 1 l.-1� �* <1 ' �(iY <br /> �Customer' <br /> � _. . <br /> Phone � - <br /> DESCRIPTION: <br /> Lot ' " ��� <br /> Block ��- <br /> Division or Addition- " ' ' `-` i - � ) -�\� �' �� _ <br /> Sewer District <br /> Monthly Sewer Service ` <br /> Remarks: - �� . <br /> Monthly Sewer Constr. - " <br /> G% r��C�>J •!i}/.�Gr��-e(.e� Q�C//.e`�� -..�-C/• /J:Y <br /> a� �.-,�., S £ �� — y ' .�'G �' s 6' APProved By . , � .- , ,.� �., � ; <br /> g'/L�wl� S' C �.cC.�. `V �--� .1 �l, �'�J ��e�-�•- CitV Engineer <br /> � ..0 c � 5�,.,.—o<• . )7 c��... i� ,�-lc�� - Issued By �.' <br /> G , <br /> .,;Q;� tL .a c o o I ' � ' <br /> � ' � _ Connection By <br /> Inspection By GL-�--= !l-'=<---% <br /> Date Insp��cted ic`�i��7 Z `� <br /> � <br /> SEE SKETCH ATTACHED <br /> INSPECTION <br />