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.: v� reli <br />�` � <br />� �-� q-2�i—� <br />� <br />�� ` � ` '� ����o � �,�'' 'L� <br />City of Everett �� l I f <br />Engineering Department <br />Sewer Applieation and Permif <br />No. "? <br />�_`j��� DATE _ <br />Service Address <br />Billing Address ' � <br />Ciry, State, Zip ' ' <br />Ovoner (Mortgagor) = < : � <br />Billing Name_ <br />Connection By � � �' � <br />Utility Account Nc <br />Connection Pennit <br />Connection Fee_ <br />Total Fee <br />Address_ � ' � f '�f � . � ' Si�ned <br />Phone_ ' <br />DESCRIPT!ON: <br />Lot <br />Block <br />Division or Addition <br />Type Permit: <br />Remarks: <br />r <br />' —�-� i � i <br />0 <br />_� ��- ..t;-�...�C.l�.� �� �A"<" <br />a- <br />SEE SKETCH AT'fACHED <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 />(� ciry Engineer <br />Issued By _ <br />Inspection By�i,�S— � ' <br />Date I nspected_ � -" �� '� � � ` � J <br />NO. <br />