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everen <br /> � \, -� , '�� � �r(�A 1 . <br /> ��r. '�� �:�(' �1� <br /> City of Everett <br /> Engineering Department <br /> Sewer Application and Permit <br /> ' , �a�J c:+.i .. <br /> NO. 1- 0 �62 DATE 7 �'�/ ��3 <br /> Service Address .1LL�' Sf 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 /> Custamer <br /> Phone ' <br /> DESCRIPTION: <br /> Lot�� <br /> Block b $'6 p <br /> Division or Addition��/�LL�II�(��S � �Q-D� <br /> Sewer District <br /> Monthly Sewer Service <br /> Remarks: <br /> Monthly Sewer Constr. <br /> � � ' <br /> Approved By ; .�- .'� <br /> A c�rv e�,9��,�« <br /> , � <br /> Issued By <br /> — Connection By <br /> Inspection By � � `���^'�"""�� <br /> Date I nspected�/��73 <br /> , <br /> � � � <br /> SEESKETCH ATTACHED , , � � <br /> � � �_ � �i <br /> ^., '-�-� <br /> � �,� � ' k.._ <br />