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evere" <br />e <br />City of Everett � l � � 2 <br />Engineering Department <br />Sewer Application and Permit <br />NO. 20612 DATE <br />Service Address__ 7 <br />Billing Address <br />City, State, Zip �� 1 <br />Owner (Mortgagor)_ f , <br />Billing Name <br />Connection By <br />Phone__ <br />DESCRIPTION: <br />Lot <br />Block <br />Division or Addition <br />Type Permit: <br />SEE SKETCH ATTACHED <br />INSPECTION <br />Utility Account No. <br />Connection Permit F <br />Connection Fee <br />Total Fee <br />Signed <br />Customer <br />Sewer District <br />Monthly Sewer Service <br />Monthly Sewer Constr, <br />Lateral <br />Abutting Lot Line <br />N, S, E, W, <br />Approved By <br />City Engineer <br />Issued <br />nspection By <br />)ate Inspected_ <br />Foo0612 <br />