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i <br /> „ EV�PJCIY "� ^ —'�-((���Z-� � <br /> e �= /.�a;� . <br /> �F�:, !'' `� �r -`��;.,,� <br /> City of Everett <br /> Engineering Depertment ��\ <br /> Sewer Application and P�erm''� <br /> No. 2098g DATE <br /> , <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 /> ; <br /> DESCRIPTION: Sewer District ' - <br /> Lot Monthly Sewer Service <br /> Block <br /> Division or Addition Monthiy Sewer Constr. <br /> 'Tru nk <br /> Type Permit <br /> Lateral <br /> Remarks: - Abutting Lut Line <br /> N S E W ft. <br /> � <br /> -� <br /> Approved By_ ' <br /> Ciry En9lneer <br /> ' Issued 3y ` <br /> Inspection By <br /> Datelnspected_ <br /> a <br /> SEE St<ETCH ATTP�:HED N�' � �l `' `' '� <br />