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everett � � `�, _ � �{- <br /> i� <br /> e �J � . _ _. _ � <br /> City of Everett <br /> Engineering Oepaitment <br /> Sewer Application and Permit <br /> N0. ,'-� ' _- ,� �� DATE /�1 (n �7 � <br /> ,� <br /> Service Address �=�'�/�� �n�' �' n�' - Utility Account No. '� - _��{ �>� �' ;"? <br /> Billing Address �r`�,'�` �r+%��' no Connection Permit Fee ''' � � '" �"� <br /> City, State, Zip �— r�F'.P r'>r�f/-�i 9�s J �� Connection Fee �" ^� `� �, �'� � � � �'� �. <br /> Owner (Mortgagor) .��r �.�,�rJ,G , n: � ; Total Fee J/":-. 'J � <br /> Billing Name ��m �" <br /> i <br /> Connection By `�6%r� �F <br /> Address //i/7 %��r ( i Signed C�r+�Li_�J„ , , r i� ,11 <br /> — a:�'"' o'r,��'" � <br /> Phone � �''� - � � �' <br /> DESCRIPTION: Sewer District 'l /_��� 'r� � <br /> ��. (� -;� c, i. i \ .'_�:.� ;, <br /> Block�— Monthly Sewer Service • ��' <br /> Division or Addition Monthly Sewer Constr. - <br /> Type Permit: �� �,, � � ; � �, . � Trunk !. / �"' <br /> Lateral ' '� <br /> Remarkr. <br /> Abutting Lot Line <br /> N, S, E, W ft. <br /> �-0 <br /> Approved By � / ��-;� , , �: „,. <br /> � City Eneineer � <br /> Issued By � �i�� � %�% � <br /> Inspection By �u�'`'=�""' <br /> Datelnspected � � 7� <br /> e <br /> SEE SKETCH ATTACHED N0. `' ; `� ^ i � <br /> ;::;-�i�,,, <br />