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_ i . . <br /> everett ' . <br /> e i - ' `' _ z �, _ 5 _ :.�. LL� 3 ,%3 /�:� ?/' <br /> � ��-- <br /> City of Everett <br /> Engineering Oeputment <br /> Sewer Application e�nd Permit <br /> 33794 � <br /> , <br /> No. 2 0 � 9 4 DATE � ' ��� <br /> Service Address '�% � "� ��'' --- Utility Account No. <br /> Biiling Address f ��L T� Connection Permit Fee � � - <br /> City, State, Zip_ � ��`� =' ��% �'�` ' � / Connection Fee <br /> -- _ — <br /> Owner In�ortgagor) � i���/f ' , ,1;;:i,-� Total Fee � � '� '� <br /> Billing Name _ f ' '�'il: <br /> � <br /> Connection By "��' ' <br /> Address_' "� % � '� % � 9 Signed %� <br /> Cusromer <br /> j i � , , <br /> Phone � � � � <br /> DESCRIPTION: Sewer District <br /> Lot _ - -- <br /> Monthly Sewer Service <br /> Block <br /> Division or Addition '% i - Monthly Sewer Constr. <br /> Trunk <br /> Type Permit: '; :�,�� ' ., <br /> Lateral <br /> Remarks: <br /> _ _ / Abutting Lot Line <br /> �O /!(S�—�'� /2.—/U-7 N, S, E, W ft. <br /> _ /�' <br /> Approved By • <br /> City EnB�neer <br /> i / . <br /> Issued By <br /> Inspection By — <br /> Datelnspected <br /> a <br /> SEE SKETCH ATTACHED N�� 2 0 7 9 4 <br /> . � ..�. � �. i . <br />