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a <br /> eVP,yCri <br /> � , ,^ <br /> � / �f� I d/�(� I l '�� <br /> City of Evereti <br /> Engineering Department <br /> Sewpr Application and Permit ���h a <br /> No. 2 0 l 14 DATE ` � ` <br /> Service Address � �7 �� `�-%j �-"' - Utility Account No. <br /> Billing Address ��`` �%��— Connection Permit Fee � -- <br /> City, State, Zip n LE��E �� �°" t` Connection Fee � <br /> Owner (Mortgagor) ,� .�'��'< <- ',�"� i'� < a = Total Fee <br /> Billing Name -::% ���� <br /> , ,-' 4 �,f=- r.. ury'-c �n <br /> Connection By - �`i�:�'-�' _' ���7 <br /> - � <br /> Address r" � �' � � - Signed �`- _ <br /> � Cusromer " � <br /> Phone � <br /> , <br /> DESCRIPTION: Sewer District <br /> Lot Monthly Sewer Service <br /> Block <br /> Division or Addition Monthly Sewer Constr. <br /> Trunk __ <br /> Type PermiL , ,s . .,�' ,, ' <br /> � Lateral <br /> Remarks: <br /> Abutting Lot Line <br /> N, S, E, W ft. <br /> Approved By <br /> � Ciry Engineer . <br /> Issued By <br /> Inspection By ( • �� ��' �S �� _ <br /> Datelnspected 7' G S ' �¢ <br /> 0 <br /> SEE SKETCH ATTACHED NO. `� (� � � !� <br /> I'::-."-(�. �, IUf4 <br />