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everett � -7�S� -`? i ��-��/ ��3/7`��� , <br /> r� �� � � <br /> C�ty of Everett <br /> Engineering Department <br /> Sewer Application and Permit � 3.;t; j � <br /> DATE . <br /> N0. 2�772 _ - . - <br /> � - Utility Account No. ' : `, <br /> ; _; i - _ _ .. <br /> Service Address Connection Permit Fee <br /> -_ -� .. , , � _ '; <br /> gflling Audress Connection Fee , <br /> _ ( I i _ _ <br /> State, Zip - ' > . , ` <br /> City, ' Total Fee <br /> pwner (Mortgagor) ` <br /> Billing Name <br /> Conneciion BY � � ` : ` " ',�;.�` � <br /> $19�ed • Customer <br /> . i . <br /> Address <br /> Phone � gewer District <br /> DESCRIPTION: MonthlY Sewer Service <br /> Lot '�— <br /> Block�� MonthlY Sewer Constr. - <br /> Division or Addition ' Trunk <br /> � - � � Lateral <br /> Type Permit: • <br /> Abutting Lot Line ft. <br /> . � : �% N S E W <br /> Remarks: <br /> APP�oved BY� �;�9;�e�� <br /> _� Issued BY�� � • - <br /> -- Y <br /> —�� ection BY �b <br /> Insp <br /> Date Inspected <br /> �i'' 1G � <br /> N0. �O7 � n <br /> a <br /> SEE SKETCH ATTACHE <br /> �-�' i�qi: <br />