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e��ereft � . � ` _ <br />P �, �,7 1 , <br />e �� �� . - <br />, ,� <br />;��- ` , -n �� <br />''i��' <br />City of Everett <br />Engineering Department <br />Sewer Application and Permit <br />N0. � Q �i !; � DATE <br />Service Address , <br />Billing Add:ess <br />City, State, Zi <br />Utility Account No. <br />Connection Permit Fee - <br />Connection <br />Owner (Mortgagor) ' Total Fee <br />Billing Name <br />Connection <br />DESCRIPTION: <br />Lot <br />Block <br />Division or Additi <br />Type Permit: <br />Signed _ <br />Cusiomer <br />Sewer District_ <br />Monthly Sewer Service <br />_ Monthly Sewer Constr. <br />— Trunk <br />Lateral _ <br />Abutting Lot Line <br />N, S, E, W <br />Approved By _ <br />City Engincer <br />Issued Bv <br />� <br />SEE SKETCH ATTACHED <br />Inspection By �'� _ <br />� <br />Date Inspected 5 ..�/ 7 <br />NO. <br />. , �— <br />