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_ - �._ . <br /> everett _ ., - - <br /> � _ �!=" - 2 � - �. :� __ ,� -. <br /> �\ . � - � -- `,_ f <br /> City of Everett <br /> � f,". <br /> Engineering Oepartment i; .' ' • <br /> Sewer Application and Permit <br /> NO. �_ 1 :i (� 'J 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 /> DESCRIPTION: Sewer District <br /> Lot_ <br /> Block Monthly Sewer Service <br /> Division or Addition Monthly Sewer Constr. <br /> Trunk <br /> Type Permit: <br /> Lateral <br /> Remarks: � ' <br /> Abutting Lot Line <br /> `, _ N, S, E, W ft. <br /> — Approved By <br /> Ciry Engineer <br /> Issued By <br /> f= /73 i�oc �n -zn � -2_�� InspectionBy �� '��+�05_$/�.Ll� <br /> Date Inspected__� — /�( — 7G <br /> a <br /> SEE SKETCH ATTACHED NG. ;� � � n ;� <br />