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�.. <br />I <br />everett <br />e <br />City of Everett <br />Engineering Denartment <br />Sewer Application and P�rr�it � <br />N0. �.L �� "� D4TE <br />Service Address ._ Utility Ar,count No. <br />Billing Addr=ss <br />City, State, Zip__ _ <br />Owner (Mortgagor) <br />Billing Name <br />Connection By <br />Address <br />Phone—_ <br />� 4 <br />'=�'� $ - Z f�- S <br />/ <br />Connection Permit Fee <br />Connection <br />Total <br />Signed__ <br />Cuvtomer <br />DESCRIPTION: <br />Sewcr District - <br />Lot — <br />Block �Aonthly Sewer Service <br />Division or Addition Monthly Sewer Constr. <br />Type FermiL• <br />SEE SKETCH ATTACHED <br />I.i;SPG�.�I I:" <br />Lateral <br />Abutting Lot Line <br />N, S, E, W. <br />Approved By <br />Ciry Enpineer � <br />Issued <br />Inspection By � –��tt� <br />�ate Inspected � 7 7 7 <br />N0. ?I��r <br />