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everett 1 ` _ - --_ _ � <br /> _ , --- _., <br /> � " !' / -- '�7 -- .�rl- ; ' - <br /> City of Everett <br /> Enpineerinp Department <br /> Sewer Application and Perm�t <br /> ,, , <br /> N0. � 1 � u � DATE �` � <br /> Service Address � ' <br /> Utility Account No. <br /> Billing Address Cannection 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 /> Oivision or Addition � Monthly Sewer Constr. <br /> Type Permit: Trunk <br /> Lateral <br /> Remarks: , , . - , <br /> • • Abutting Lot Line <br /> _y.—� , < � - -_ N, S, E, W <br /> ft. <br /> Approved By <br /> City Engineer <br /> Issued By <br /> Inspection By_��_� ,��, �,�_��,� <br /> o D�te Inspected_� 4 - '7 G <br /> � <br /> SEE SKETCH ATTACHED NO. "' i "' �S ;� <br /> .� <br /> '- — <br /> �� <br />