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everett � <br /> �; <br /> City of Everett <br /> Engineering Depertment i <br /> Sewer Application and Permit <br /> NO. � .1�> ;'�1 DATE � ' <br /> � <br /> Service Address Utility Account No. <br /> Billing Address Connection Permit Fee <br /> City, State, Zip - Connection Fee _ <br /> Owner (Mortgagor) Total Fee <br /> Billing Name . <br /> Connection By <br /> Address Signed <br /> Customer <br /> Phone <br /> DESCRIPTION: Sewer District <br /> Lot <br /> Block Monthly Sewer Service <br /> Division or Addition Monthly Sewer Constr. <br /> — Trunk <br /> Type Permit: <br /> Laterel <br /> Remarks: <br /> Abutting Lot Line <br /> -- . . -. :c; — i= -�r—.,s. < � ; N, S, E, W ft. <br /> -�' � .'Yr C•'_"'.n,'"� �• . – —� _1.��7. ,i <br /> Y�1 <br /> Approved By <br /> City Enpineer <br /> Issued By <br /> Inspectian By_ ' � _ <br /> Date Inspected `�/9�� <br /> o— <br /> SEE SKETCH ATTACHED NO. _ _', �� I �,' <br />