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F � : <br />everett ' ' ; <br />e , ,,,, , <br />,� <br />��>> <br />. �;,:; <br />i�i ,,:; <br />City of Everett � <br />Engineering & Community Services <br />Sewer Applicatrion d�d Per�nit <br />� <br />N0. � � ^� J =� DATE �- _:. �� �_� <br />.--i.__.--- <br />Service Address 1 U i i�� ;-- �;-'_ <br />Billing Address __. <br />City, State, Zip __ _. <br />Owner (fvlortgagor) __ <br />Billing Name _ <br />i. - .� �—_ <br />Connection By i� �:-i �s� . 1 <br />i <br />i,, <br />Aridrecc � ✓ <br />DESCRIPTION: <br />Lot Block <br />Plat <br />Unplatted Description <br />Type Permit: <br />9 <br />Utility Account No, <br />Permit Fee ' <br />Connection Charge(s) "'� <br />Total <br />, <br />Signed _;<:'�j� :�� <br />SEE SKETCH ATTACHED <br />I���:-;'� .�li�`� <br />Sewer District__ <br />Monthly Se�ver Service. <br />Monthly Se�v=r Constr. <br />Trunk <br />Lateral_ <br />Abutting Lot Line <br />N, S, E, W <br />Approved 8y i <br />Ciry Engineer <br />�: <br />Issued Bv ' - <br />Inspeccion By <br />Date Insp�ctee <br />u <br />� <br />