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� <br />eve�.tt <br />e <br />City of Everett <br />Engineerinp Department <br />�.., .� ,?; � -� �, <br />-,� _3 5--29- � <br />: <br />=� '.S- �,r <br />t ,; .f f s <br />Sewer Application and Pern�i�} <br />NO. �� 1,5 _L 7 DATE <br />Service Address_ - <br />Billing Address <br />City, State, Zip <br />Owner (Mortgagor)' <br />Billing Name <br />Connection By <br />Address <br />Phone <br />DESCR�PTION: <br />Block_ <br />Division or Addition <br />Type Permit: <br />Utility Account No. <br />Connection Permit I <br />Connection Fee_ <br />Total Fee <br />Signed <br />Customer <br />SEESKETCH ATTACHED <br />If'�;PEC�I�I(�; ; <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 />Ciry Engineer <br />Issued <br />/��.- ��-�-� <br />.., '"�'�, <br />Inspection By df<<-l� ;� �� -�� <br />� <br />Date I nspected ��eY�� <br />No. 2 i.317 <br />