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everett . �/�G � ����� <br /> � ;� - zo - ? R -5 <br /> City of Everett <br /> Engineering Department <br /> Sewer Application and Permit � <br /> NO. � � J =� � DATE <br /> Service Address_ Utility Account No. <br /> Billing Address Con�ection 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 /> Blockl�(� Monthly Sewer Service <br /> . <br /> Division or Addition - Monthly Sewer Constr. <br /> Trunk <br /> Type Permit: <br /> Laterel ' <br /> Remarks: <br /> Abutting Lot Line <br /> N, S, E, W ft. <br /> Approved By <br /> Ciry Engineer <br /> Issued By <br /> Inspection By �+'�✓ �a���'�'� <br /> Date Inspected��ia��G� <br /> a <br /> SEE SKETCH ATTACHED NO. '� ! ;� �", !� <br /> I"`;I�L:�:'TI�.�i�J <br />