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�� <br /> everett . '�" <br /> � � ��`= <_ . <br /> �� �'.., ^1�-- �h� 4.. ...a <br /> .�. . <� <br /> City of Everett <br /> Engineering Department <br /> Sewer Applicotion and Permit <br /> N0. r �_ ��; i� ,� DATE � � <br /> � ` <br /> Service Address Utility Account No. _ <br /> Billing Adc+ress 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 Monthly Sewer Constr. <br /> Type Permit: Trunk <br /> Laterel <br /> Remarks: � � <br /> Abuttiny Lot Line <br /> N, S, E, W ft. <br /> Approved By <br /> Ciry Engineer <br /> — Issued By <br /> Inspection By ' <br /> a Date Inspected _ <br /> SEE SKETCH ATTACHED N0. ;' �_ �� /' ;� <br /> , . ;�-: : i�., . <br />