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everen <br /> � � 1 � . ' '��)� � 3�yi�S :����- <br /> o _ s�- S_- .,��. <br /> �' L � <br /> City of Everett <br /> Engineering Department , <br /> Sewer Application and Permit ;j ;3 � ;,; <br /> NG. '��, O cg. � 8 DATE <br /> Service Address Utility Account No. —_ <br /> Billing Address Connection Permit Fee <br /> City, State, Zip % " ' _ Connection Fee - <br /> Owner (Mortgagor) Total Fee <br /> Billing Name <br /> Connection By ' ' <br /> Address Signed <br /> Customcr <br /> Phone — <br /> DESCRIPTION: Sewer District <br /> Lot " Monthly Sewer Service_ <br /> Block <br /> Division or Addition . Montlily Sewer Constr. <br /> Trunk <br /> Type Permit: <br /> ' Lateral <br /> Remarks: �. ,,, . .��j -- Abutting Lat Line <br /> , _ N S E, W ft. <br /> ,. - - .> - <br /> �'q ' � 1 -f s- ' "— <br /> Appruved By <br /> ' � . , _ - CitV Engineer <br /> r � — <br /> Issued By <br /> •�-�- <br /> Inspection By <br /> Date Inspected <br /> 0 <br /> SEE SKETCH ATTACHED N�• � � , � ��� �� <br /> IP�`.:�,��-��;,,� <br />