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Ll <br />City of Everett <br />Engineering Department <br />Sewer Application and Permit <br />NO. O 7 i', '� DATE / <br />Service Address " /��'�� f �� i Utility Account No <br />Billing Address J(✓ t` <br />City, State, Zip L 6 G`I'E`27 , /1/d 1 <br />Owner (Mortgagor) 1,4; e <br />Billing Na <br />t. <br />Connection By �Le I{- i S <br />Address <br />Phone - <br />DESCRIPTION: <br />Lot <br />Connection Permit �ee r" - <br />Connection Fee <br />Total Fee � <br />Sewer District <br />'Customer <br />Block Monthly Sewer Service <br />Division or Addition 14 Monthly Sewer Constr. <br />Tvue Permit: <br />Remarks: <br />SEE SKETCH .ATTACHED <br />Trunk <br />Abutting Lot Line <br />N,S,E,W <br />Approved By <br />City Engineef <br />Issued By — <br />Inspection By <br />Date Inspected <br />NO. <br />