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. "e rereii <br />� <br />City of Everett <br />Engineering Department <br />Sewer Application and Permi� <br />^� <br />NO. �= .I- ; ' � �' DATE <br />6310 <br />Service Address <br />Billing Address <br />City, State, Zip <br />Owner (Mortgagc�) — <br />Billing Name <br />Connection By_ <br />Phone <br />DF.SCRIPTION: <br />Lot <br />Block <br />Divisio� or Addition <br />, Tvne Permit: <br />� <br />� �'� �' <br />� � �' . <br />Utility Account No. <br />Connection Permit I <br />Connection Fee_ <br />Total Fee <br />Signed <br />Sewer District <br />Monthly Sewer Service. <br />Monthly Sewer Constr. <br />B <br />SEE SKETCH ATTACkED <br />Abutting Lot Line <br />N, S, E, W. <br />Approved By — <br />City Ensineer <br />I ssued <br />Inspection By�� � <br />Date I nspected �— �' 3 - � <br />No. ?_1?''' <br />