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everett � . - � <br /> � �� v �=. ,..� . ' ' ' <br /> � � �,� ,� � a� � � <br /> , .- •� //; <br /> , <br /> /,�,j <br /> City of Everett % , �'�1 �� <br /> � <br /> Engineering Department j <br /> Sewer Application and Permit� ,3 4 n ;� �, <br /> No. 2094 � DATE ' � � : <br /> Service Address �� � �' f 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 /> cusmmer <br /> Phone <br /> DESCRIPTION: Sewer District <br /> Lot <br /> Block Monthly Sewer Service <br /> Division or Addition Monthly Sewer Constr. <br /> Trunk <br /> Type PermiL• <br /> Lateral <br /> Remarks: �� � P — GaNNEC —E To �iisT, <br /> Abutting Lot Line <br /> � _ ,re i,✓ F,e. P o . ti .os E,� N, S, E, W ft. <br /> ETC . <br /> Approved By_. <br /> City En9ineer <br /> Issued By __ <br /> i , / ,_.,./ <br /> Inspection By �- ' . � f��r�'�/ <br /> Date I nspected �/�/-� <br /> 0 <br /> SEE SKETCH ATTACHED NO. �� 1� g (� � <br /> ��1";P�i1 fl;;'� <br />