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City of Everett <br />Engineering Department <br />Sewer AK <br />o�nd Permit <br />N0. r: I �J ` :. DATE _ <br />Service /,ddress�Q,�.�-.� � �l���Ld <br />Billing Address <br />City, State, Zip <br />Own, r (Mortgagor) <br />Billing Name <br />Connection By <br />Utility Account No. <br />Connection Permit I <br />Connection Fee_ <br />Total Fee <br />DESCRIP?ION: Sewer District__ <br />Lot 'L7 <br />Block (��7r_ MonthlySewerService. <br />, l <br />Division or Addition F>��E�# � Monthly Sewer Constr. <br />- Trunk _ <br />Type Permi[: <br />Abutting Lot Line <br />N, S, E, W <br />Approved By <br />City Engineer <br />SEE SKETCH ATTACHED N0. 2 I_ G i`� <br />i�:F',' �. �il���'� <br />