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everett ,.;: .; .- ..- - - <br /> e �. .- _ _ �.� � �_ , <br /> City of Everett <br /> Engineering Department <br /> Sewer Application and Permit <br /> N0. L � � ,� ;' DATE <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 Monthiy Sewer Constr. <br /> Type Permit: Trunk <br /> Lateral <br /> Remarks: <br /> Abutting Lot Line <br /> N, S, E, W ft. <br /> Approved By <br /> Ci�y EnBineer <br /> Issued By <br /> Inspection By <br /> e Datelnspected <br /> SEE SKETCH ATTACHED N0. '� I �'t ; �� <br />