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� <br /> .; . <br /> evr'eri .G�: � . ._ <br /> r'-) � � _' <br /> � ' �- /l �) ' ., ., <br /> f � •L <br /> (� j !, r*: �1,, <br /> l_' ,;'' <br /> City of Everett <br /> Engineering Department <br /> Sewer Applicatior� and Permit <br /> 33r3 � <br /> No. 20589 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 /> Customer <br /> Phone_ <br /> DESCRIPTION: Sewer District � <br /> Lot <br /> Block Monthly Sewer Service <br /> Division or Addition_ Monthiy Sewer Constr. <br /> Trunk <br /> Type Permit: <br /> Lateral � <br /> flemarks: <br /> Abutting Lot Line <br /> � N, S, E, W ft. <br /> Approved By <br /> � � ' Ciry Enginecr ' <br /> Issued By <br /> Inspection By <br /> Date Inspected <br /> e <br /> SEE SKETCH ATTACHED No. ? 0 5 R 9 <br /> r:�si�rcr��.�,��� <br /> - -- — J . <br />