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ev.e►Pfl <br />..� ,, <br />c,_� i'� � l�-I �- 7 1 <br />City of Everett �:L� <br />Engineering Department <br />Sewer Application and P�rmit <br />N0. e�1. ll � IJ �r� '� DATE <br />_S5U � ,F'c, c �'c-!h//e �? <br />Servicu Address ` <br />Billing Address <br />City, State, Zip <br />Owner (Mortga <br />Billing Name_ <br />Connection By. <br />Address_ <br />J� <br />Utility Account No. <br />Connection P�rmit I <br />Connection Fee_ <br />Total Fee _ <br />/� <br />usiomcr <br />DESCRIPTION: <br />Lot � S <br />Block__5 Li�7,'�t�� <br />Division or AdditionL_A_l1�EL ��./�:�%r S <br />Sewer District { <br />— �� �L��� ��� Monthly Sewer Service_ <br />Remarks: <br />,, _ „ „� �. � / i , � Monthly Sewer Constr._ <br />.YI <br />SEE SKETCH ATTACH[D <br />Approved <br />Issued <br />Connection <br />3225� <br />Z . S G <br />i <br />n J � I '� <br />Engineer <br />Inspection By /�P—_ ^� � /�+'�r �� — <br />/ <br />✓ <br />Date Inspected_ � � 7"�— <br />