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.everett / <br /> e � � � �� � � � � <br /> , <br /> , � � 7�- �- � - � ;;� �C� .�'iy'�5� <br /> v <br /> City ot Everett <br /> Engineering Department I�� <br /> Sewer� Application and Permit <br /> , - <br /> 33 �6« � <br /> No. 2 0 8 3 3 DATE .' - -- , '~%'� _ <br /> Service Address ' %" 1 � � ' '` � � ��� � Utility Account No. <br /> Billing Address "' �' ��'� Connection Permit Fee <br /> City,State, Zip - '� � %� ' � Connection Fee _ <br /> Owner (Mortgagor) �.:• 1`"� • ��f.�����'I� i` Total Fee <br /> Billing Name -''t,'�1:��`� <br /> , _ r-- <br /> Connectian By i% , `'�'"�f i ' <br /> Address Signed_ <br /> cusiomer <br /> Phone <br /> DESCRIPTION: Sewer District <br /> Lot <br /> Block Monthly Sewer Service <br /> Division or Addition " - Monthly Sewer Constr. <br /> Type Permit: Trunk <br /> ,f. <br /> Lateral <br /> � <br /> Remarks: ;�, ,_,� � ;�/ -. . <br /> Abutting Lot Line <br /> ' � N, S, E, W ft. <br /> , ..• <br /> � ce..� /I7 .�l �S �'`� . . <br /> Approved By <br /> Ciry Engineer <br /> Issued By <br /> Inspection ByCB� �P7 _ <br /> Date I nspected � z -3 - � y <br /> n <br /> SEE SKETCH ATT.4CHED N0. Z (� g j � <br /> !NSPf-�.;110i; <br />