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everett �_ <br />� - - _ � % � %1� � <% ' � �:�/�' �?� � <br />-1�� ;,f <br />City of Eve.rett <br />Engineering Department <br />Sewer Applicatiora and Permit <br />No. 2 0 7 51 DATE <br />Service Address <br />Billing Address <br />City, State, Zip <br />Owner (PAortgagor� <br />Billing Name <br />Connection 6y <br />Address <br />Phone <br />UESCPIPTION: <br />Lot <br />Block_ <br />Division or Additicn. <br />Type �ermit: <br />Utility Acccunt No._ <br />Connection Permit Fee_ <br />Connection Fee <br />Total Fee <br />Sign <br />SEE SKETCH ATTACHED <br />Sewer District <br />Monthly Sewer Service <br />Monthly Sewer Constr. <br />Trunk <br />Lateral <br />Abutting Lot Line <br />N, S, E, W <br />3;3'724 <br />Approved By <br />Ciq- Engineer <br />ISSUCd <br />�� <br />�!� � ��JJ <br />Inspection By ,(�..,� � <br />1 <br />Date Inspected__�j��� Y _. <br />� <br />NO. �� n i !; 'i <br />,_. . <br />