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I -' <br /> _ _ i �, _ �_ ,., <br /> everelt ' <br /> � � (, <br /> City of Everett ' <br /> Engineering Depertment <br /> Sewer App�:�ation anc� Permit 32404 <br /> No.�OQ65 � DATE �� � � �� <br /> Service Address ��� � n ��� 7� Utility Ac:�unt No. <br /> 00 <br /> Billing Address Connection Permit Fee ��• <br /> City, State, Zip Connection Fee <br /> v <br /> Owner (Mortgagor) Total Fee ��• �� <br /> Billing Name <br /> Connection By <br /> - Signed �' -- <br /> AddtC55___ � Customer <br /> Phone <br /> DESCRIPTION: <br /> Lot — ' <br /> Block <br /> Division or Addition <br /> Sewer District <br /> ,/ Monthly Sewer Service <br /> Remarks: / GAiG/� �BS/� <br /> Monthly Se ver Constr. <br /> �� 7� Approved BY Ciry Engincer <br /> ` ✓ Issued By <br /> Connection By <br /> Inspection By�L-'-- <br /> Date Inspected � �`� �" <br /> :YI <br /> SEE SKETCH ATTACHED �,, _;n�CTION <br /> . • <br />