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� � . , � � <br /> �everett �� _ ` , �� ' <br /> -� �_i <br /> el .� � �_.� �� �J,.,; <br /> City of Everett <br /> ' Engineering Uepartment <br /> Sewer Application and Permit <br /> 33 ? � A <br /> No.'�0448 '� DATE � ' <br /> Service Address - �' ` � Utility Account No. <br /> Connection Permit Fee — <br /> Billing Address , <br /> City, State, Zip - � Connection Fee <br /> pwner (Mortgagor) Total Fee — <br /> Billing Name <br /> Connection By - - — <br /> Address � � Signed Cusmmer <br /> ` ' / <br /> � Phone_ <br /> IDESCRIP?ION: <br /> Lot <br /> Bluck_ <br /> Division or Addition - <br /> Sewer District <br /> Monthly Sewer Service '- . <br /> Remarks: � ' — <br /> Monthly Sewer Constr. <br /> �y�—y ".a�,w-� ^- � APProved BY � <br /> � Ciry Engincc� <br /> i <br /> ���✓� �-Q�.�„}o� �l c, Issued By <br /> ��„�_�,�,l���n�R- - Connection By <br /> --- Inspection By_�9--��`�h <br /> —� Date I nspected � 2!y( 7 3 <br /> m <br /> SEE SKETCH ATTACHED �I�C�,I'�:�:Tl���i <br />