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everett � � " ."/ ,/' �— G/ . <br /> � �; � l�/S <br /> � � .. �� ' - <br /> �r> > � <br /> City of Everett �, � <br /> Engineering Department <br /> ,iv./�r <br /> Sewer Appiication and Permit <br /> rvo. 2 0 811 DATE ,i; ,, ' � i ' . :< '��'�'�r_ <br /> Service Address_. ' ' / '' � �� �r�` ` Utility Account No. <br /> Billing Address f �/1"l� Connection Permit Fee - <br /> City, State, Zip_'�-lf '<<l� •' r i � �1 '-. 1! ConnectionFee <br /> � � r yr . <br /> Owner (Mortgagor) ` � ''� �' •���r✓f� /`�� Total Fee � <br /> Billing Name • , � ' ,���" ' � % -'' •/% <br /> Connection By %f <br /> �� � <br /> Address _ Signed-- "`-� " ' <br /> Customer <br /> Phone �� - %'� t ', � <br /> DESCRIPTION: Sewer District <br /> Lot <br /> Block Monthly Sewer Service <br /> Division or Addition ' ' `� Monthly Sewer Constr. <br /> Trunk <br /> Type Permit: ;�' r';-� ' , _� ;f , <br /> Lateral <br /> Remarks: <br /> Abutting Lot Line <br /> /v0 - - 7,_$ N, S, E, W ft. <br /> Approved By <br /> Ciry Engineer' <br /> — — Issued By <br /> Inspection By!/ . � L" V�' <br /> Date I nspected � - �6- 7� _ <br /> e <br /> SEE SKETCH ATTACHED N0. ` �I � 'j 1 <br />